CHADS2 Score is a Poor Predictor of Non-cerebral Acute Arterial Occlusion in Patients with Non-valvular Atrial Fibrillation

Abstract

OBJECTIVE: The CHADS2 score is a stroke risk stratification scheme in patients with non-valvular atrial fibrillation (NVAF). The aim of this study was to determine whether the CHADS2 score can help to predict the risk of non-cerebral acute arterial embolism.MATERIALS AND METHODS: One hundred and seventeen patients who underwent surgery for non-cerebral acute arterial embolism with NVAF between 1997 and 2009 were enrolled in the cross sectional study. The CHADS2 score of each patient was calculated at the onset of symptoms. The distribution of the CHADS2 score was compared with that of other studies analyzing patients with stroke.RESULTS: The perioperative mortality was 11.1%. A comparison of patients with stroke revealed that our distribution curves were significantly shifted to the left, showing that the CHADS2 score did better in predicting stroke than non-cerebral embolism. On the other hand, the distribution in our series coincides with that of NVAF patients in general. These results indicated that the risk of non-cerebral embolism occurs at the same rate regardless of the CHADS2 score.CONCLUSIONS: The CHADS2 scoring system seems to be an unreliable predictor of non-cerebral embolism, and may not contribute in avoiding potentially life-threatening acute arterial occlusion of the peripheral artery.