Evaluation of the Use of CHA2DS2-VASc Scoring System to Predict Ischemic Stroke in Patients with non Valvular Atrial Fibrillation: A Single Center Experience


ABSTRACT:BACKGROUND:Stroke in patients with non-valvular AF is a major cause for disability and increasing morbidity andmortality, CHA2DS2-VASc is a tool for assessing the risk of stroke in these patientsOBJECTIVE:This study was conducted to evaluate the use of CHA2DS2-VASc scoring system in a sample of Iraqipatients with embolic stroke and non valvular atrial fibrillationPATIENTS AND METHODS:A cross-sectional study was done in Baghdad Teaching Hospital that enrolled 60 patients with nonvalvularatrial fibrillation who presented with a first-time ischemic stroke. Data was collected usinga questionnaire, CHA2DS2-VASc score was calculated (excluding 2 points of stroke for allpatients), and also HAS-BLED score was calculated.RESULTS:In this study, there was a statistically significant association between age groups and CHA2DS2-VASc scores, as most patients with low scores were in younger age groups and most of patients withhigher scores were in older age groups. The same association was found between sex and CHA2DS2-VASc scores, noting that the majority of the study group were females (70.0%). The most frequentrisk factor was hypertension which was diagnosed in (85.0%) of the study group, followed by heartfailure (51.7%), and diabetes mellitus (40.0%), while the presence of vascular diseases was the leastcommon (26.7%). Warfarin use was recorded in only 7(11.7%) patients. There was no statisticallysignificant association between CHA2DS2-VASc and HAS-BLED scores.CONCLUSION:CHA2DS2-VASc was a valuable tool for assessing risk of embolic stroke, yet, there was a lowfrequency of anticoagulation use which was not explained by HAS-BLED scores. Hypertension andheart failure were the most common among study group, followed by diabetes mellitus.