SynthesisTexas Heart Institute journal2015
Meta-analysis of CHADS2 versus CHA2DS2-VASc for predicting stroke and thromboembolism in atrial fibrillation patients independent of anticoagulation.
Synthesis in Texas Heart Institute journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Effect of non-vitamin K antagonist oral anticoagulants versus warfarin in heart failure patients with atrial fibrillation.Heart failure reviews · 2021Pooled it
- Real-world use of nonvitamin K antagonist oral anticoagulant in atrial fibrillation patients with liver disease: A meta-analysis.Clinical cardiology · 2020Pooled it
- Pooled it
- Pooled it
- Non-Vitamin K Antagonist Oral Anticoagulants Versus Warfarin in Patients With Cancer and Atrial Fibrillation: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2019Pooled it
- Pooled it
- Oral Anticoagulation Therapy in Atrial Fibrillation Patients with Intermediate Stroke Risk: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- The MindMoves Trial: Cross-Sectional Analyses of Baseline Vascular Risk and Cognition in Older Women with Cardiovascular Disease.Journal of Alzheimer's disease : JAD · 2024Trial
- The Left Atrial Appendage in Sinus Rhythm and Atrial Fibrillation: From Functional Structure to Potential Thromboembolic Reservoir, Rationale for Medical or Radical Exclusion.Journal of clinical medicine · 2025Review
- The Predictive Value of Circulating Gal-3 for New Stroke Events in Paroxysmal Atrial Fibrillation Patients Despite Oral Anticoagulation Medications.Clinical cardiology · 2025Article
- The Value of Clinical Prediction Models in General Practice: A Qualitative Study Exploring the Perspectives of People With Lived Experience of Depression and General Practitioners.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Feasibility of multiorgan risk prediction with routinely collected diagnostics: a prospective cohort study in the UK Biobank.BMJ evidence-based medicine · 2024Observational
- Article
- Stroke in Patients with Atrial Fibrillation: Epidemiology, Screening, and Prognosis.Journal of clinical medicine · 2023Review
- Prognostic value of CHATurk gogus kalp damar cerrahisi dergisi · 2023Article
- Atrial fibrillation in UK South Asian hospitalized ischemic stroke patients: The BRAINS study.PloS one · 2023Article
- Validation of CHA2DS2 VASc Score Predictability of Stroke and Systemic Embolization in a Middle Eastern Population with AF: The Jordan Atrial Fibrillation (JoFib) Study.Vascular health and risk management · 2023Article
- Study on the predictive ability of emergency CHADSJournal of thoracic disease · 2022Article
- Comparative analysis of left atrial appendage closure efficacy and outcomes by CHAFrontiers in cardiovascular medicine · 2022Article
- Usefulness of CHADS2, R2CHADS2, and CHA2DS2-VASc scores for predicting incident atrial fibrillation in heart failure with preserved ejection fraction patients.ESC heart failure · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Two validated scoring systems for predicting embolic risk, CHADS2 and CHA2DS2-VASc, contribute to optimizing antithrombotic prescription practices in patients who have atrial fibrillation. However, data about anticoagulated patients are sparse. We compared CHADS2 and CHA2DS2-VASc, in terms of their predictive risk evaluation, in patients with atrial fibrillation who were and were not taking anticoagulants. We systematically searched the Cochrane Library, PubMed, and Embase databases for studies of the comparative diagnostic performance of CHADS2 and CHA2DS2-VASc. We identified 12 cohort studies for meta-analysis. With regard to the occurrence of cardiovascular events individually, patients with CHA2DS2-VASc scores ≥2 have a greater risk of stroke (risk ratio [RR]=5.15; 95% confidence interval [CI], 3.85-6.88; P <0.00001) and thromboembolism (RR=5.96; 95% CI, 5.50-6.45; P <0.00001) (P diff=0.34) than do patients with CHA2DS2-VASc scores <2, independent of anticoagulation therapy (RR=5.76; 95% CI, 5.23-6.35; P <0.00001 in anticoagulated patients; and RR=6.12; 95% CI, 5.40-6.93; P <0.00001 in patients not taking anticoagulants; P diff=0.45). The pooled RR estimates indicate an approximate 6-fold increase in the risk of endpoint events in patients with CHA2DS2-VASc scores ≥2 (RR=5.90; 95% CI, 5.46-6.37; P <0.0001). These results clearly indicate the discriminative capacity of the CHA2DS2-VASc score for stroke, thromboembolic events, or both, independent of optimal anticoagulation. The CHA2DS2-VASc score enables the identification of patients who are at genuinely high risk and can direct the selection of appropriate therapeutic approaches.
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