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Scores of Providencia et al Combining Echocardiographic Parameters with CHADS2 and CHA2DS2-VASC to Predict Risk of Stroke in Atrial Fibrillation

Description

Providencia et al modified existing risk scores for stroke in patients with atrial fibrillation by the addition of points for findings seen on echocardiography. This can improve the performance of the scores. The authors are from University College London, Hospitais da Universidade de Coimbra and Universidade Federal do Ceara.


Existing scores for predicting risk of stroke in atrial fibrillation:

(1) CHADS2 (scores range from 0 to 6)

(2) CHA2DS2-VASC (scores range from 0 to 9)

 

Echocardiographic parameters:

(1) left ventricular ejection fraction in percent

(2) left atrial area in square cm

 

Parameter

Finding

Points

left ventricular ejection fraction

> 54%

0

 

45 to 54%

1

 

<= 44%

2

left atrial area

< 24 square cm

0

 

24 to 32.5 sq cm

1

 

> 32.5 sq cm

2

 

score for echocardiography findings =

= (points for the 2 echocardiography findings)

 

modified CHADS2 =

= (CHADS2) + (score for echocardiography findings)

 

modified CHA2DS2-VASC =

= (CHA2DS2-VASC) + (score for echocardiography findings)

 

Interpretation:

• minimum scores: 0

• maximum score for echocardiography findings: 4

• maximum modified CHADS2 score: 10

• maximum modified CHA2DS2-VASC: 13

 

Performance:

• Figure 1 shows the various ROC curves for the different test combinations.


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