Arrhythmias & electrophysiology
Comparison of the ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc stroke risk scores in predicting ischaemic stroke in a large Swedish cohort of patients with atrial fibrillation
Authors' conclusion
In this SAF cohort, the ATRIA score predicted ischaemic stroke risk better than CHADS2 or CHA2DS2-VASc.
Study context
- Population
- Swedish patients hospitalized or visiting a hospital-based outpatient clinic with atrial fibrillation (AF), not receiving warfarin, July 2005–December 2010not receiving warfarin
- Participants
- 152,153 patients
- Exposure
- ATRIA vs CHADS2 vs CHA2DS2-VASc stroke risk scores
- Outcome
- Prediction of acute ischaemic stroke (C-index, NRI)
Methodological detailsnational cohort, nationwide registry, Variables determined from comprehensive national databases
- National cohort
- Nationwide registry
- Variables determined from comprehensive national databases
Main finding
As reported in the abstract
Ischaemic stroke prediction, C-index (entire point scores)
Net reclassification improvement (NRI)
0.16
CI 0.14–0.17
ATRIA vs CHADS2
NRI
0.21
CI 0.20–0.23
ATRIA vs CHA2DS2-VASc
ATRIA
0.708
C-index · CI 0.704–0.713
CHADS2
0.690
C-index · CI 0.685–0.695
CHA2DS2-VASc
0.694
C-index · CI 0.690–0.700
Observational data: associations, not effects.
Further findings
Acute ischaemic stroke incidence
- Acute ischaemic strokes observed
- 11 053
- Mean stroke rate (vs 2%/year in California cohorts)
- 3.2%/year
C-index with published low/moderate/high risk cut-points
- C deteriorated but ATRIA remained superior
NRI with cut-points altered to fit cohort stroke rates
- NRI decreased
Original publication
Comparison of the ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc stroke risk scores in predicting ischaemic stroke in a large Swedish cohort of patients with atrial fibrillation. Eur Heart J. Published 3 March 2016. doi:10.
Summarised from the published abstract; every number is checked against it