Incremental value of estimated glomerular filtration rate in improving stroke risk stratification in patients with and without atrial fibrillation considered to be low risk by CHA2DS2VASc score


Aurora Research Institute

Aurora Cardiovascular Services

Aurora Sinai/Aurora St. Luke's Medical Centers

Sheikh Khalifa bin Hamad Al Thani Center for Integrative Research on Cardiovascular Aging


BACKGROUND: CHA 2 DS 2 VASc scoring system is a useful clinical tool to characterize stroke risk in patients with and without atrial Fibrillation (AF), yet thromboembolic complications occur in patients deemed low risk for stroke (0-1 score for AF and 0-3 score for non-AF patients). We hypothesized that incorporating information about renal dysfunction will improve risk stratification of patients with CHA 2DS 2 VASc score of 0 to 3.

METHODS: Consecutive patients with or without AF evaluated at a large community based academic medical center from 2012 to 2015 were identified and those with a CHA 2 DS 2 VASc Score of 0-3 assessed for incident stroke. Based on estimated glomerular filtration rate (eGFR) relative improvement in risk stratification of stroke in AF and non-AF patients were determined using cochrane armitage test.

RESULTS: The overall proportion of stroke over 3 years mean follow-up in patients with or without AF with baseline CHA 2 DS 2 VASc score 0-3 with eGFR and improvement in risk stratification is summarized in Table.

CONCLUSIONS: In patients considered low risk by CHA 2 DS 2 VASc score, incorporating eGFR information improves risk stratification and decision for anticoagulation.

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