Table 2.
Risk Stratification Tools for Stroke Risk in Atrial Fibrillation57
| Tool and Citation | Risk Factor* | Score | Tool Score (if Stated) | Annual Event Rate, % (if Stated) |
|---|---|---|---|---|
| CHADS241 | CHADS2 score | Adjusted stroke rate | ||
| CHF (recent) | 1 | 0 | 1.9 | |
| Hypertension (history of) | 1 | 1 | 2.8 | |
| Age ≥75 y | 1 | 2 | 4.0 | |
| DM | 1 | 3 | 5.9 | |
| Stroke/TIA | 2 | 4 | 8.5 | |
| 5 | 12.5 | |||
| (6 = max. score) | 6 | 18.2 | ||
| CHA2DS2-VASc54 | CHA2DS2-VASc score | TEE rate | ||
| CHF/LV dysfunction | 1 | 0 | 0 | |
| Hypertension | 1 | 1 | 0.6 | |
| Age ≥75 y | 2 | 2 | 1.6 | |
| DM | 1 | 3 | 3.9 | |
| Stroke/TIA/TE | 2 | 4 | 1.9 | |
| Vascular disease (prior MI, PAD, or aortic plaque) | 1 | 5 | 3.2 | |
| Age 65–74 y | 1 | 6 | 3.6 | |
| Sex category (female) | 1 | 7 | 8.0 | |
| 8 | 11.1 | |||
| (9 = max. score) | 9 | 100 | ||
| R2CHADS255 | ||||
| Renal dysfunction (CrCl <60 mL/min) | 2 | |||
| CHF (recent) | 1 | |||
| Hypertension | 1 | |||
| Age ≥75 y | 1 | |||
| DM | 1 | |||
| Stroke/TIA | 2 | |||
| (8 = max. score) | ||||
| QStroke (QResearch database Stroke)56,57 | Age (at entry) y | Range, 25–84 | ||
| Sex | Separate models for male and female | |||
| Treated hypertension (diagnosis of hypertension and ≥1 current prescription for ≥1 antihypertensive agent) | Yes/No | |||
| T1DM | Yes/No | |||
| T2DM | Yes/No | |||
| AF | Yes/No | |||
| CHF | Yes/No | |||
| CHD | Yes/No | |||
| Self-assigned ethnicity (White/not recorded, Indian, Pakistani, Bangladeshi, other Asian, Black Caribbean, Black African, Chinese, other/mixed) | 9 categories | |||
| Townsend Deprivation Score | Continuous | |||
| Smoking status (nonsmoker, ex-smoker, light smoker [<10 cigarettes/day], moderate smoker [10–19 cigarettes/day], heavy smoker [≥20 cigarettes/day]) | 5 categories | |||
| SBP | Continuous | |||
| TC:HDL-C ratio | Continuous | |||
| BMI | Continuous | |||
| Family history of coronary disease (in first-degree relative age <60 y) | Yes/No | |||
| RA | Yes/No | |||
| CKD | Yes/No | |||
| Valvular heart disease | Yes/No | |||
| (99% = max. score) | ||||
| ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Stroke58 | Prior stroke | |||
| Without | With | |||
| Age, y | ||||
| ≥85 | 6 | 9 | ||
| 75–84 | 5 | 7 | ||
| 65–74 | 3 | 7 | ||
| <65 | 0 | 8 | ||
| Female sex | 1 | 1 | ||
| DM | 1 | 1 | ||
| CHF | 1 | 1 | ||
| Hypertension | 1 | 1 | ||
| Proteinuria | 1 | 1 | ||
| eGFR <45 mL/min/1.73 m2 or ESRD | 1 | 1 | ||
| (12 = max. score) | (15 = max. score) | |||
AF = atrial fibrillation; BMI = body mass index; CHD = coronary heart disease; CHF = congestive heart failure; CKD = chronic kidney disease; CrCl = creatinine clearance; DM = diabetes mellitus; eGFR = estimated glomerular filtration rate; ESRD = end-stage renal disease; HDL-C = high-density lipoprotein cholesterol; LV = left ventricular; MI = myocardial infarction; PAD = peripheral artery disease; RA = rheumatoid arthritis; SBP = systolic blood pressure; T1 = type 1 (DM); T2 = type 2 (DM); TC = total cholesterol; TE = thromboembolism; TEE = thromboembolic event; TIA = transient ischemic attack.
*
First letter of each row spells out the acronym, unless otherwise stated.