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Modest Predictive Accuracy for CHA2DS2-VASc in Heart Failure

Clinical utility in patients with heart failure remains to be determined

MONDAY, Aug. 31 2015 (HealthDay News) -- The predictive accuracy of the CHA2DS2-VASc score for ischemic stroke, thromboembolism, and death in patients with heart failure with and without concomitant atrial fibrillation (AF) is modest, according to findings published online Aug. 30 in the Journal of the American Medical Association to coincide with the annual European Society of Cardiology Congress, held from Aug. 29 to Sept. 2 in London.

Line Melgaard, from Aalborg University in Denmark, and colleagues examined whether CHA2DS2-VASc predicts ischemic stroke, thromboembolism, and death among patients with heart failure, with and without AF. Data were included for 42,987 patients not receiving anticoagulation who were diagnosed with incidence heart failure during 2000 to 2012 (21.9 percent had concomitant AF).

The researchers found that the risks of ischemic stroke, thromboembolism, and death were 3.1, 9.9, and 21.8 percent, respectively, with risks increasing with CHA2DS2-VASc scores, for those with and without concomitant AF. In this population, C-statistics and negative predictive values indicated that the CHA2DS2-VASc score performed modestly for those with and without AF (for ischemic stroke: one-year C-statistic, 0.67 and 0.64, respectively; one-year negative predictive values, 92 and 91 percent, respectively).

"Predictive accuracy was modest, and the clinical utility of the CHA2DS2-VASc score in patients with heart failure remains to be determined," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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