Arrhythmias & electrophysiology
Refining the CHA2DS2VASc risk stratification scheme: shall we drop the sex category criterion?
Authors' conclusion
Removing Sc from the CHA2DS2VASc score does not affect its ability to discriminate thromboembolic events in the population with AF.
Study context
- Population
- Patients with atrial fibrillation (AF), UK, followed 1998–2016126,428 non-anticoagulated
- Participants
- 195,719 patients
- Exposure
- CHA2DS2VA vs CHA2DS2VASc score
- Outcome
- Ischaemic stroke or systemic embolism
Methodological detailsUK primary and secondary care data
- UK primary and secondary care data
Main finding
As reported in the abstract
Discrimination of thromboembolic events
C-statistics similar for both scores over the years
0.62 to 0.71
Net reclassification improvement (NRI): improved reclassification in lower thromboembolic risk groups
11%
NRI: misclassification in higher-risk patients, without change in anticoagulation indication
−7%
Observational data: associations, not effects.
Further findings
Sex differences in thromboembolic risk
- No sex difference in lower-risk population; higher stroke rates in women with CHA2DS2VA ≥2
Original publication
Refining the CHA2DS2VASc risk stratification scheme: shall we drop the sex category criterion? Europace. Published 10 November 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →