Usefulness of the CHADS and RCHADS scores for prognostic stratification in patients with coronary artery disease.

OBJECTIVE

The current risk model for long-term prediction in coronary artery disease (CAD) is complicated, while a simple useful model is still lacking. We aim to investigate if CHADS and RCHADS scores could predict long-term outcome for patients with CAD.

PATIENTS AND METHODS

We enrolled 3,700 patients with CAD between November 2010 and September 2014 at the Department of Cardiology from Chinese PLA General Hospital. The CHADS and RCHADS scores were calculated. All cases were followed to track the incidence of composite end point consisting of cardiovascular (CV) death, myocardial infarction (MI), stroke, heart failure, and all-cause death.

RESULTS

During a median 2.9-year follow-up, 443 patients experienced at least one element of the composite end point of CV death (n=168 [4.6%]), MI (n=59 [1.6%]), stroke (n=96 [2.6%]), heart failure (n=101 [2.8%]), and all-cause death (n=240 [6.6%]). Multivariate Cox regression analyses showed that the CHADS score (hazard ratio [HR]: 2.18, 95% CI: 2.00-2.38, <0.0001) and the RCHADS score (HR: 1.93, 95% CI: 1.83-2.04, <0.0001) were independently associated with composite outcome. Receiver-operating characteristic analysis showed that compared with the CHADS score, the RCHADS score had better discrimination for the prediction of long-term combined outcome (0.772 vs 0.791, =0.0013).

CONCLUSION

CHADS and RCHADS scores provide a quick and useful tool in predicting long-term outcome for patients with CAD.