In this large Danish cohort of patients with nonvalvular Afib, the predictive ability of the CHADS2 score was compared to the expanded CHA2DS2-Vasc score. The latter score adds 1 point for age 65-74, 2 points for age >74, 1 point for female sex, and 1 point for any vascular disease. The predictive value was slightly better for the latter score, with an AUC of 0.88 for the CHA2DS2-Vasc versus and AUC of 0.81 for the CHADS2 score. It is not yet clear if this new scoring system will be adopted by US professional societies. The upgraded scoring system reclassifies a large majority of (old) low risk to intermediate risk, and (old) intermediate risk to high risk (necessitating more patients be on anticoagulants versus aspirin). (abstract)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.