The CHA2DS2-VASc score and the risk of ischemic stroke in community-dwelling individuals with and without atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study

Abstract type: clinical research. presentation type: oral presentation. introduction: recent evidence from hospital-based cohorts suggests that the cha2ds2-vasc score may be used to predict ischemic stroke in individuals without atrial fibrillation (af). we aimed to evaluate the association of the cha2ds2-vasc score for incident ischemic stroke,with and without af,among community-dwelling individuals. methodology: we included all participants from the atherosclerosis risk in communities (aric) study who attended visit 4 (1996-98) and had no prior af,stroke,and were not on warfarin. incident af was ascertained from study ecgs and hospital discharge diagnosis codes,and stroke was physician-adjudicated. af cases were matched with non-af controls based on cha2ds2-vasc variables,and participants were censored if they began anticoagulants during the follow-up period. time-to-event and competing risk analyses were used to calculate the incidence rates of ischemic stroke by cha2ds2-vasc score,stratified by af status. results: this analysis included 4,039 participants (mean age,74.6. ±. 6.8. years; 50% women; 14% blacks) of whom 1,180 had incident af. after a mean follow-up of 5.1. ±. 4.2. years,182 (4.5%) developed ischemic stroke. higher cha2ds2-vasc score was associated with higher incidence of ischemic stroke in participants with and without af. in participants without af,the absolute 1-year risk remained low (0.6%) even in those with cha2ds2-vasc score of ≥6. in participants with af,the absolute 1-year risk of ischemic stroke was 3.2% even in those with cha2ds2-vasc score of 0-1). conclusion: the risk of ischemic stroke is low across cha2ds2-vasc score categories in community-dwelling individuals without af. individuals with af are at high risk for ischemic stroke even with low cha2ds2-vasc score,suggesting the need for stroke prevention in individuals with af and one cha2ds2-vasc stroke risk factor. © 2017.