Steensig et al reported the CHADS-P2A2RC Score to predict the risk of an arterial thromboembolic event in a patient without atrial fibrillation. This can help to identify a patient who may benefit from antithrombotic therapy The authors are from Aarhus University, Odense University Hospital, Aalborg University Hospital, University of Liverpool, and McMaster University.
CHADS refers to congestive heart failure, hypertension, age 65-74, diabetes mellitus, smoking.
P2A2 refers to peripheral arterial disease and age >= 75 (items scored 2 points).
RC refers to renal disease and coronary artery disease.
Patient selection: adults >= 55 years
Outcomes: primarily MACE, also stroke
Parameters:
(1) congestive heart failure
(2) hypertension
(3) diabetes mellitus
(4) renal disease, moderate or severe
(5) age in years
(6) active smoking
(7) multi-vessel coronary obstruction
(8) peripheral arterial disease
|
Parameter
|
Finding
|
Points
|
|
congestive heart failure
|
no
|
0
|
|
|
yes
|
1
|
|
hypertension
|
no
|
0
|
|
|
yes
|
1
|
|
diabetes mellitus
|
no
|
0
|
|
|
yes
|
1
|
|
renal disease
|
no
|
0
|
|
|
yes
|
1
|
|
age in years
|
< 65 years
|
0
|
|
|
65 to 74 years
|
1
|
|
|
>= 75 years
|
2
|
|
active smoking
|
no
|
0
|
|
|
yes
|
1
|
|
multi-vessel obstruction
|
no
|
0
|
|
|
yes
|
1
|
|
peripheral arterial disease
|
no
|
0
|
|
|
yes
|
2
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score 10
|
Score
|
Risk of Events
|
|
0 or 1
|
low
|
|
2 or 3
|
intermediate
|
|
>= 4
|
high
|
