Background
Methods
Study design
Data source
Study population
Variables
Risk Factor | Points | |
---|---|---|
C | Congestive heart failure | 1 |
H | Hypertension | 1 |
A2 | Age ≥ 75 years | 2 |
D | Diabetes mellitus | 1 |
S2 | Prior Stroke or transient ischemic attac | 2 |
V | Vascular disease | 1 |
A | Age 65 to 74 years | 1 |
Sc | Sex category (female) | 1 |
Range of possible scores | 0 to 9 |
Statistical methods
Sensitivity analysis
Results
With OAC (N = 82,331) | Without OAC (N = 30,229) | |
---|---|---|
Age (mean ± SD) | 77.12 ± 8.75 | 76.41 ± 12.42 |
Sex (percent male) | 47.7% | 46.6% |
CHA2DS2-VASc-score (mean ± SD) | 4.66 ± 1.57 | 4.25 ± 1.81 |
Hypertension | 91.6% | 85.0% |
Chronic heart failure | 47.7% | 40.2% |
Stroke or transient ischemic attack in 2014 | 10.1% | 7.96% |
Stroke in 2014 | 6.4% | 4.71% |
Diabetes mellitus | 44.3% | 10.1% |
Vascular disease | 50.6% | 12.0% |
Alcohol-related disorder | 3.2% | 5.2% |
Dementia | 11.3% | 19.2% |
Anemia | 16.2% | 19.9% |
Renal disease | 32.8% | 31.90% |
Dialysis | 0.9% | 2.5% |
Liver disease | 15.7% | 15.0% |
CHA2DS2-VASc | N | ischemic strokes | Thrombembolic events | Bleeding | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
events | incidence rate (per 100py) | 95%-CI | events | incidence rate (per 100py) | 95%-CI | events | incidence rate (per 100py) | 95%-CI | |||||
0 | 721 | 1 | 0.08 | 0.01 | 0.55 | 4 | 0.31 | 0.12 | 0.82 | 2 | 0.15 | 0.04 | 0.62 |
1 | 1881 | 16 | 0.48 | 0.30 | 0.79 | 26 | 0.79 | 0.54 | 1.16 | 11 | 0.33 | 0.19 | 0.60 |
2 | 2636 | 47 | 1.08 | 0.82 | 1.44 | 83 | 1.92 | 1.55 | 2.37 | 21 | 0.48 | 0.32 | 0.74 |
3 | 4208 | 85 | 1.30 | 1.05 | 1.60 | 137 | 2.10 | 1.78 | 2.47 | 34 | 0.52 | 0.37 | 0.72 |
4 | 6394 | 215 | 2.31 | 2.02 | 2.63 | 332 | 3.58 | 3.22 | 3.98 | 84 | 0.90 | 0.73 | 1.11 |
5 | 6784 | 243 | 2.58 | 2.28 | 2.93 | 390 | 4.18 | 3.79 | 4.60 | 87 | 0.92 | 0.75 | 1.14 |
6 | 4823 | 200 | 3.27 | 2.86 | 3.75 | 341 | 5.62 | 5.07 | 6.24 | 78 | 1.28 | 1.02 | 1.59 |
7 | 2066 | 107 | 4.18 | 3.47 | 5.04 | 164 | 6.44 | 5.55 | 7.46 | 31 | 1.21 | 0.85 | 1.71 |
8 | 530 | 33 | 5.31 | 3.81 | 7.39 | 53 | 8.58 | 6.64 | 11.10 | 10 | 1.59 | 0.86 | 2.93 |
9 | 186 | 14 | 7.22 | 4.36 | 11.96 | 23 | 12.27 | 8.37 | 18.0 | 4 | 2.03 | 0.77 | 5.35 |
Total | 30,229 | 961 | 2.20 | 2.07 | 2.34 | 1553 | 3.55 | 3.38 | 3.73 | 362 | 0.83 | 0.75 | 0.92 |
CHA2DS2-VASc | Wicke et al. | Lip (6) | Friberg (7) | van den Ham (8) | Kim (9) | Singer (10) | Olesen (11) | Allan (12) | ||
---|---|---|---|---|---|---|---|---|---|---|
IS | TE | TE | IS | TE | IS | IS | TE | TE | IS | |
0 | 0.1 | 0.3 | 0 | 0.2 | 0.3 | 0.4 | 0.2 | 0.0 | 0.7 | 0.2 |
1 | 0.5 | 0.8 | 0.6 | 0.6 | 0.9 | 0.8 | 1.0 | 0.6 | 1.5 | 0.7 |
2 | 1.1 | 1.9 | 1.6 | 2.2 | 2.9 | 1.9 | 1.9 | 0.8 | 2.9 | 1.4 |
3 | 1.3 | 2.1 | 3.9 | 3.2 | 4.6 | 2.8 | 2.5 | 1.7 | 4.3 | 2.6 |
4 | 2.3 | 3.6 | 1.9 | 4.8 | 6.7 | 3.7 | 4.7 | 2.8 | 6.5 | 4.0 |
5 | 2.6 | 4.2 | 3.2 | 7.2 | 10 | 5.1 | 5.8 | 4.3 | 10.0 | 6.2 |
6 | 3.3 | 5.6 | 3.6 | 9.7 | 13.6 | 7.1 | 8.4 | 4.8 | 12.5 | 12.1 |
7 | 4.2 | 6.4 | 8.0 | 11.2 | 15.7 | 9.0 | 8.8 | 4.8 | 14.0 | 14.5 |
8 | 5.3 | 8.6 | 11.1 | 10.8 | 15.2 | 9.0 | 7.8 | 14.1 | 17.6 | |
9 | 7.2 | 12.3 | 100 | 12.2 | 17.4 | 15.5 | 16.6 | 15.9 | 24.3 | |
Total | 2.2 | 3.6 | ~ 2.4a | 4.5 | 6.2 | 2.9 | 4.0 | 2.1 | n/ab | 3.8 |
CHA2DS2-VASc | ischemic stroke incidence rates (per 100 person-years) [95%-confidence intervals] | |||
---|---|---|---|---|
outpatient diagnosis N = 18,915 | inpatient diagnosis N = 6887 | in- and outpatient diagnosis N = 4427 | only permanent atrial fibrillation (ICD-10: I48.2) N = 5033 | |
0 | 0.11 [0.02–0.76] | 0 | 0 | 0 |
1 | 0.44 [0.24–0.79] | 0.82 [0.31–2.16] | 0.35 [0.05–2.47] | 1.47 [0.48–4.51 |
2 | 1.18 [0.86–1.61] | 0.57 [0.22–1.52] | 1.25 [0.47–3.32] | 0.94 [0.31–2.91] |
3 | 1.24 [0.97–1.59] | 1.61 [1.02–2.55] | 1.15 [0.52–2.55] | 1.87 [1.11–3.13] |
4 | 2.26 [1.93–2.65] | 2.26 [1.66–3.06] | 2.70 [1.85–3.95] | 3.83 [2.90–5.06] |
5 | 2.39 [2.03–2.81] | 2.39 [1.83–3.13] | 3.80 [2.89–5.01] | 2.84 [2.13–3.77] |
6 | 2.67 [2.17–3.28] | 3.50 [2.72–4.51] | 4.69 [3.61–6.08] | 3.99 [3.04–3.77] |
7 | 3.68 [2.75–4.92] | 3.99 [2.84–5.60] | 5.54 [3.94–7.80] | 5.25 [3.70–7.43] |
8 | 4.86 [2.73–8.65] | 4.25 [2.32–7.80] | 7.48 [4.34–12.89] | 5.47 [2.79–10.74] |
9 | 5.38 [2.08–13.96] | 8.07 [3.48–18.71] | 8.67 [3.74–20.05] | 6.63 [2.57–17.08] |