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首页> 外文期刊>The American heart journal >The CHADS2 score predicts ischemic stroke in the absence of atrial fibrillation among subjects with coronary heart disease: data from the Heart and Soul Study.
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The CHADS2 score predicts ischemic stroke in the absence of atrial fibrillation among subjects with coronary heart disease: data from the Heart and Soul Study.

机译：CHADS2评分可预测患有冠心病的受试者中不存在房颤的缺血性卒中：来自“心脏与灵魂研究”的数据。

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BACKGROUND: We sought to evaluate the prognostic performance of the CHADS(2) score for prediction of ischemic stroke/transient ischemic attack (TIA) in subjects with coronary heart disease (CHD) without atrial fibrillation (AF). METHODS: In 916 nonanticoagulated outpatients with stable CHD and no AF by baseline electrocardiogram, we calculated CHADS(2) scores (congestive heart failure, hypertension, age >/=75 years, diabetes [1 point each], and prior stroke or TIA [2 points]). The primary outcome was time to ischemic stroke or TIA over a mean follow-up of 6.4 +/- 2.3 years. RESULTS: Over 5,821 person-years of follow-up, 40 subjects had an ischemic stroke/TIA (rate 0.69/100 person-years, 95% CI 0.50-0.94). Compared with subjects with low (0-1) CHADS(2) scores, those with intermediate (2-3) and high (4-6) CHADS(2) scores had an increased rate of stroke/TIA, even after adjustment for age, tobacco, antiplatelet therapy, statins, and angiotensin inhibitors (CHADS(2) score 2-3: HR 2.4, 95% CI 1.1-5.3, P = .03; CHADS(2) score 4-6: HR 4.0, 95% CI 1.5-10.6, P = .006). Model discrimination (c-statistic = 0.65) was comparable with CHADS(2) model fit in published AF-only cohorts. CONCLUSIONS: The CHADS(2) score predicts ischemic stroke/TIA in subjects with stable CHD and no baseline AF. The event rate in non-AF subjects with high CHADS(2) scores (5-6) was comparable with published rates in AF patients with moderate CHADS(2) scores (1-2), a population known to derive benefit from stroke prevention therapies. These findings should inform efforts to determine whether stroke prevention therapies or screening for silent AF may benefit subjects with stable CHD and high CHADS(2) scores.
机译：背景：我们试图评估CHADS（2）评分对无心房颤动（AF）的冠心病（CHD）患者缺血性中风/短暂性脑缺血发作（TIA）的预后性能。方法：通过基线心电图检查在916名CHD稳定且无房颤的非抗凝门诊患者中，我们计算了CHADS（2）得分（充血性心力衰竭，高血压，年龄> / = 75岁，糖尿病（每个得分1分）以及先前的卒中或TIA [ 2分]）。主要结局是缺血性卒中或TIA的时间，平均随访时间为6.4 +/- 2.3年。结果：超过5,821人-年的随访，有40名受试者患有缺血性中风/ TIA（发生率0.69 / 100人-年，95％CI 0.50-0.94）。与具有低（0-1）CHADS（2）得分的受试者相比，具有中等（2-3）和高（4-6）CHADS（2）得分的受试者中风/ TIA发生率升高，即使在调整了年龄之后，烟草，抗血小板疗法，他汀类药物和血管紧张素抑制剂（CHADS（2）得分2-3：HR 2.4，95％CI 1.1-5.3，P = .03; CHADS（2）得分4-6：HR 4.0，95％ CI 1.5-10.6，P = .006）。模型区分（c统计量= 0.65）与已发布的仅AF队列中的CHADS（2）模型拟合相当。结论：CHADS（2）评分可预测患有稳定冠心病且无基线房颤的受试者的缺血性卒中/ TIA。 CHADS（2）得分高（5-6）的非房颤患者的事件发生率与CHADS（2）得分中等（1-2）的房颤患者的发生率相当（已知该人群可从中风预防中获益）疗法。这些发现应有助于确定中风预防疗法或筛查无声房颤是否有益于稳定冠心病和高CHADS（2）评分的受试者。

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