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Original Research

Med Arch. 2011; 65(1): 27-29


Limitations of CHADS, Scoring System in Predicting Stroke Risk - Need to Change the Age Criteria

Blerim Berisha, Masar Gashi, Xhevdet Crasniqi, Ejup Pllana, Dardan Kocinaj.




Abstract

Introduction: Atrial fibrillation (AF) is the most common arrhythmia with a strong association with age. The aim of this study was to evaluate the rate of stroke in relation to age and anticoagulation status based on CHADS˛ risk criteria. Methods: This study included all patients with non-valvular atrial fibrillation admitted to our clinic between 1/11/2007 and 1/11/2009, with minimum one year follow up for patients without stroke. We calculated risk based on CHADS˛ (C-cardiac failure, H- hypertension, A-age >75 years, D-diabetes mellitus, S-stroke) point system and evaluated anticoagulation status at the moment of first occurrence of stroke. We observed the rate of stroke in different group age. Results: The average of participants with AF was 67.9±10.3 years. Amongst 302 patients with non-valvular atrial fibrillation, 32.5% had been anticoagulated while 13.9% of experienced stroke . The stroke were more present in patients who used aspirin in age group 65-74 (22.5%, P=0.014). The mean age of patients who experienced stroke were 67.2, SD±10.8 vs 71.6, SD±5.1, P=0.000. Of the patients with stroke from age group 65-74 years, 23 were in CHADS˛ 0-1 scoring system. Conclusion: The higher rate of stroke was in the 65-74 years age group, with CHADS˛ scoring system 0-1, and without anticoagulation therapy. Therefore modification has to be considered for the CHADS˛ scoring system to account the age as a risk factor for population in different regions.

Key words: Atrial fibrillation, Age, Anticoagulation, Stroke.






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