Arrhythmias & electrophysiology
Stroke risk stratifications according to CHA2DS2-VASc vs. CHA2DS2-VA in patients with atrial fibrillation: insights from the GLORIA-AF registry
Main finding · Prescription of oral anticoagulant (OAC)Result — go to the resultOdds ratio 0.90 95% CI 0.83–0.97Authors' conclusion
CHA2DS2-VA score had similar predictive performance for thromboembolic events compared with CHA2DS2-VASc score. The role of female sex in the management and outcomes of patients with AF may differ according to age. Whether the omission of the female criterion from CHA2DS2-VA would lead to less OAC use in female AF patients over the next years remains to be seen.
Study context
- Population
- Patients with atrial fibrillation (AF) with available dataAF patients with available data included in the analysis (mean age 70.2 ± 10.3 years, 44.9% female)
- Participants
- 21,260 patients
- Exposure
- Performances of CHA2DS2-VA and CHA2DS2-VASc scores in stratifying the risk of ischaemic stroke and thromboembolism (TE); risk of ischaemic stroke and TE, and the use of oral anticoagulants in male and female patients with AF
- Outcome
- Prescription of oral anticoagulant (OAC)
Main finding
As reported in the abstract
Odds ratio
0.90
95% CI 0.83–0.97
Female patients vs male patients
odds ratio 0.90 (95% CI 0.83–0.97)
- Interaction between sex and age, with a lower likelihood of receiving oral anticoagulant (OAC) among younger female patients
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Ischaemic strokeFemale patients vs male patients | 1.14 (0.85–1.53) | |
| Thromboembolism (TE)Female patients vs male patients | 1.02 (0.82–1.26) | |
| 0.512Hazard ratio (log scale) |
AUC
| Outcome | Female patients | Male patients | CHA2DS2-VA | CHA2DS2-VASc | P value | |
|---|---|---|---|---|---|---|
| Predictive ability for TE (AUC)CHA2DS2-VA vs CHA2DS2-VASc · similar | Not reported in the abstract | Not reported in the abstract | 0.641 (95% CI 0.585–0.697) | 0.636 (95% CI 0.580–0.692) | P = 0.593 | female patients, male patients: not reported in the abstract |
| Predictive ability for ischaemic stroke (AUC)CHA2DS2-VA vs CHA2DS2-VASc · similar | Not reported in the abstract | Not reported in the abstract | 0.660 (95% CI 0.582–0.739) | 0.646 (95% CI 0.568–0.725) | P = 0.847 | female patients, male patients: not reported in the abstract |
- Ischaemic stroke: similar between male and female patients; order of groups not stated in the abstract
- Thromboembolism (TE): similar between male and female patients; order of groups not stated in the abstract
TE by sex and age
- Possible interaction between sex and age, with a higher risk of TE in younger female patients
- P = 0.051
Original publication
Stroke risk stratifications according to CHA2DS2-VASc vs. CHA2DS2-VA in patients with atrial fibrillation: insights from the GLORIA-AF registry. Eur Heart J Cardiovasc Pharmacother. Published 28 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it