TABLE 9.
Some Best Known Published Clinical Scores With Potential Advantages
| Year of Publication, Score Name |
Score Components | Potential Advantages | No. of Validation Studies19 |
Hyperlink to Online Score Calculator, if Available |
|---|---|---|---|---|
| 2001 CHADS2 25 | CHF, hypertension, age (≥65 y is 1 point, ≥75 y is 2 points), diabetes, stroke/TIA (2 points) | CHADS2 was superior to existing risk classification schemes AFI scheme: C-statistic, 0.68 (0.65-0.71) SPAF-III scheme: C-statistic, 0.74 (0.71-0.76) CHADS2 score: C-statistic, 0.82 (0.80-0.84) |
46 | https://www.mdcalc.com/calc/40/chads2-score-atrial-fibrillation-stroke-risk |
| 2010 CHA2DS2-VASc2 | CHF, hypertension, age ≥75 y, diabetes, stroke or TIA, vascular disease, age 65-74 y, female sex | Most commonly used and studied, superior to CHADS2 score. C-statistic, 0.606 (0.513-0.699 for CHA2DS2-VASc score vs 0.561 (0.450-0.672) for CHADS2 score Improved compared with original CHADS2 score |
82 | https://www.mdcalc.com/calc/801/cha2ds2-vasc-score-atrial-fibrillation-stroke-risk#next-steps |
| 2013 ATRIA 1 | Age (65-74 y is 3 points, 75-84 y is 5 points, ≥85 y is 6 points), hypertension, diabetes, CHF, proteinuria, GFR <45 mL/min/1.73 m2, sex | Includes more age categories, renal function, and proteinuria More patients were classified as low or high risk but not as well tested in general. | 11 | https://www.mdcalc.com/calc/1842/atria-stroke-risk-score |
| 2017 GARFIELD-AF 3 | Web-based, uses routinely collected clinical data, and includes a total of 16 questions | Web-based tool for predicting stroke and mortality, includes the effect of the different anticoagulants, bleeding risk and mortality to facilitate shared decision-making on the potential benefits/risks of anticoagulation | 4 | https://af.garfieldregistry.org/garfield-af-risk-calculator |
| 2016 MCHA2DS2-VASc 26 | Expanded lower threshold for age to 50 y (1 point for age 50-74 y) | Validated in Asian cohort Can further identify Asian AF patients who may derive benefits from stroke prevention. In 1 study, MCHA2DS2-VASc was superior to CHA2DS2-VASc C-statistics = 0.708 (0.703-0.712) vs 0.689 (0.684-0.694) |
1 |
ATRIA indicates Anticoagulation and Risk Factors in Atrial Fibrillation: anemia, renal disease, elderly (age ≥75 y), any previous bleeding, hypertension; CHADS2, congestive heart failure, hypertension, age >75 y, diabetes, stroke/transient ischemia attack/thromboembolism; CHA2DS2 -VASc, indicates congestive heart failure, hypertension, age ≥75 y (doubled), diabetes mellitus, prior stroke or transient ischemic attack or thromboembolism (doubled), vascular disease, age 65 to 74 y, sex category; CHF, congestive heart failure; GARFIELD-AF, Global Anticoagulant Registry in the Field-Atrial Fibrillation; GFR, glomerular filtration rate; SPAF-III, stroke prevention atrial fibrillation, and TIA, transient ischemic attack.