One-year Clinical Prediction in Chinese Ischemic Stroke Patients Using the CHADS2 and CHA2DS2-VASc Scores: The China National Stroke Registry

Abstract

Aims: We investigated whether CHADS2 or CHA2DS2-VASc scores could be used to predict 1-year prognosis in stroke recurrence, mortality, and mortality of ischemic stroke or transient ischemic attack (TIA) patients with nonvalvular atrial fibrillation (NVAF). Methods: Patients were selected from a national prospective registry in China. The clinical prediction of the scores was examined using the C statistic. Univariate and multivariate logistic regressions were performed to analyze the relevant risk factors. Results: Thousand two hundred and ninety-seven of 22,216 patients were enrolled in the study. For stroke recurrence rate, the C statistic value was 0.53 (odds ratio [OR] 1.15, 95% confidence interval [CI]: 1.01 to 1.32) for CHADS2 and 0.55 (OR 1.14, 95% CI: 1.05 to 1.24) for CHA2DS2-VASc; adding baseline National Institutes of Health Stroke Scale (NIHSS) score to these two scores, the value of C statistic was 0.58 (OR 1.25 95% CI: 1.14 to 1.37) and 0.58 (OR 1.19, 95% CI: 1.11 to 1.27), respectively. Conclusions: Both CHADS2 and CHA2DS2-VASc scores have limitations in predicting the 1-year prognosis of stroke/TIA patients with NVAF in China. The predictive value of these two scores improved by adding the baseline NIHSS score. © 2012 Blackwell Publishing Ltd.