Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr 5:13:565-571.
doi: 10.2147/CIA.S156208. eCollection 2018.

Usefulness of the CHADS2 and R2CHADS2 scores for prognostic stratification in patients with coronary artery disease

Yuerui Li  1 , Juan Wang  1 , Lyu Lv  1 , Cui Xu  1 , Hongbin Liu  1
Affiliations

Usefulness of the CHADS2 and R2CHADS2 scores for prognostic stratification in patients with coronary artery disease

Yuerui Li et al. Clin Interv Aging. .

Abstract

Objective: The current risk model for long-term prediction in coronary artery disease (CAD) is complicated, while a simple useful model is still lacking. We aim to investigate if CHADS2 and R2CHADS2 scores could predict long-term outcome for patients with CAD.

Patients and methods: We enrolled 3,700 patients with CAD between November 2010 and September 2014 at the Department of Cardiology from Chinese PLA General Hospital. The CHADS2 and R2CHADS2 scores were calculated. All cases were followed to track the incidence of composite end point consisting of cardiovascular (CV) death, myocardial infarction (MI), stroke, heart failure, and all-cause death.

Results: During a median 2.9-year follow-up, 443 patients experienced at least one element of the composite end point of CV death (n=168 [4.6%]), MI (n=59 [1.6%]), stroke (n=96 [2.6%]), heart failure (n=101 [2.8%]), and all-cause death (n=240 [6.6%]). Multivariate Cox regression analyses showed that the CHADS2 score (hazard ratio [HR]: 2.18, 95% CI: 2.00-2.38, p<0.0001) and the R2CHADS2 score (HR: 1.93, 95% CI: 1.83-2.04, p<0.0001) were independently associated with composite outcome. Receiver-operating characteristic analysis showed that compared with the CHADS2 score, the R2CHADS2 score had better discrimination for the prediction of long-term combined outcome (0.772 vs 0.791, p=0.0013).

Conclusion: CHADS2 and R2CHADS2 scores provide a quick and useful tool in predicting long-term outcome for patients with CAD.

Keywords: CHADS2 score; R2CHADS2 score; coronary artery disease; prognosis; renal function; risk factors.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Event-free survival curve for patients according to the CHADS2 score. Note: CHADS2, congestive heart failure, hypertension, age, diabetes, and stroke/transient ischemic attack.
Figure 2
Figure 2
Event-free survival curve for patients according to the R2CHADS2 score. Note: R2CHADS2, renal dysfunction, congestive heart failure, hypertension, age, diabetes, and stroke/transient ischemic attack.
Figure 3
Figure 3
ROC curves for the CHADS2 and R2CHADS2 scores for predicting events. Note: CHADS2, congestive heart failure, hypertension, age, diabetes, and stroke/ transient ischemic attack; R2CHADS2, renal dysfunction, congestive heart failure, hypertension, age, diabetes, and stroke/transient ischemic attack. Abbreviations: AUC, area under the curve; ROC, receiver operating characteristic.
See this image and copyright information in PMC

References

    1. Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, Nichols M. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J. 2016;37(42):3232–3245. - PubMed
    1. Tang EW, Wong CK, Herbison P. Global registry of acute coronary events (GRACE) hospital discharge risk score accurately predicts long-term mortality post acute coronary syndrome. Am Heart J. 2007;153(1):29–35. - PubMed
    1. Antman EM, Cohen M, Bernink PJ, et al. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making. JAMA. 2000;284(7):835–842. - PubMed
    1. Rietbrock S, Heeley E, Plumb J, van Staa T. Chronic atrial fibrillation: Incidence, prevalence, and prediction of stroke using the Congestive heart failure, Hypertension, Age >75, Diabetes mellitus, and prior Stroke or transient ischemic attack (CHADS2) risk stratification scheme. Am Heart J. 2008;156(1):57–64. - PubMed
    1. Huang SS, Chen YH, Chan WL, Huang PH, Chen JW, Lin SJ. Usefulness of the CHADS2 score for prognostic stratification of patients with acute myocardial infarction. Am J Cardiol. 2014;114(9):1309–1314. - PubMed

MeSH terms