CHADS-VASc score as a predictor of long-term cardiac outcomes in elderly patients with or without atrial fibrillation.

BACKGROUND

The CHADS-VASc score is often used for stroke risk stratification in atrial fibrillation (AF) patients. However, its usefulness in patients ≥75 years of age with or without AF is unclear.

OBJECTIVE

We aimed to investigate whether the CHADS-VASc score can predict ischemic stroke (IS), transient ischemic attack, thromboembolism (TE), and mortality in elderly patients with and without AF.

MATERIALS AND METHODS

During 2013-2014, 1,071 patients (36.3% with concomitant AF) at least 75 years old were enrolled, and the follow-up ended on July 15, 2017. Variables included sociodemographic characteristics, complications, drugs taken, laboratory results, and echocardiographic parameters. The primary end points were IS, transient ischemic attack, and TE, expressed as IS/TE. All-cause mortality was a secondary end point. Survival curves and mortality risks were assessed via Kaplan-Meier survival analysis and compared by log-rank tests.

RESULTS

The average follow-up duration was 2.57±1.37 years. Overall, 167 patients (5.6%) died and 77 (7.2%) developed IS/TE. The CHADS-VASc score was associated with IS/TE in patients 75 years or older with and without AF, and patients with a CHADS-VASc score ≥5 had a higher risk of stroke. However, the CHADS-VASc score was not related to all-cause mortality.

CONCLUSION

The CHADS-VASc score can predict IS/TE, but not mortality, in elderly patients (≥75 years) with or without AF.