Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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The usefulness of newly developed R2CHA2DS2-VASc score and comparison with CHADS2 and CHA2DS2-VASc scores in atrial fibrillation patients

심방세동 환자에서 새로 개발된 R2CHA2DS2-VASc score 유용성 및 CHADS2, CHA2DS2-VASc scores와의 비교연구

  • Kwak, Jae-Hoon (Department of Internal Medicine, Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Yeo, Se-Hwan (Department of Internal Medicine, Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Kim, Yeo-Un (Department of Internal Medicine, Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Lee, Jin-Suk (Department of Internal Medicine, Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Kim, Byong-Kyu (Division of Cardiology, Department of Internal Medicine, Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Chung, Jin-Wook (Division of Cardiology, Department of Internal Medicine, Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Bae, Jun-Ho (Division of Cardiology, Department of Internal Medicine, Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Nah, Deuk-Young (Division of Cardiology, Department of Internal Medicine, Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Lee, Kwan (Department of Preventive Medicine, Dongguk University College of Medicine)
  • 곽재훈 (동국대학교 의과대학 경주병원 내과) ;
  • 여세환 (동국대학교 의과대학 경주병원 내과) ;
  • 김여운 (동국대학교 의과대학 경주병원 내과) ;
  • 이진석 (동국대학교 의과대학 경주병원 내과) ;
  • 김병규 (동국대학교 의과대학 경주병원 심장내과) ;
  • 정진욱 (동국대학교 의과대학 경주병원 심장내과) ;
  • 배준호 (동국대학교 의과대학 경주병원 심장내과) ;
  • 나득영 (동국대학교 의과대학 경주병원 심장내과) ;
  • 이관 (동국대학교 의과대학 예방의학교실)
  • Received : 2016.04.07
  • Accepted : 2016.05.27
  • Published : 2016.06.30
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Abstract

Background: The decision to administer oral anticoagulation therapy depends on accurate assessment of stroke risk in patients with atrial fibrillation (AF). Various stroke risk stratification schemes have been developed to help inform clinical decision making. The CHADS2 and CHA2DS2-VASc scores have been used in estimating the risk of stroke in patients with AF. Recently R2CHA2DS2-VASc score was developed. The objective of the current study is to validate the usefulness of the R2CHA2DS2-VASc score and to compare the accuracy of the CHADS2, CHA2DS2-VASc, and R2CHA2DS2-VASc scores in predicting a patient's risk of stroke. Methods: Based on medical records, we conducted a retrospective study of patients hospitalized with AF from March 2011 to July 2013. A total of 448 AF patients were included in this study. The receiver operating characteristic (ROC) curve analysis in MedCalc was used for comparison with respective diagnostic values. Results: The patient characteristics showed male predominance (60.9%). Among the 448 AF patients, 131 (29.2%) patients had strokes during the study. A R2CHA2DS2-VASc score of more than 5 is the optimal cut-off value for prediction of stroke. A risk score of three, the area under the ROC curve (AUC) of R2CHA2DS2-VASc score (AUC 0.631; 95% confidence interval, 0.585-0.679) was the highest. A significant difference was observed between AUC for R2CHA2DS2-VASc, CHADS2, and CHA2DS2-VASc scores, but no meaningful difference between CHADS2 and CHA2DS2-VASc scores. Conclusion: We determined the usefulness of the R2CHA2DS2-VASc score, which showed better association with stroke than the CHADS2 and CHA2DS2-VASc scores.

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References

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