Meta-analysis of CHADS2 Score in Predicting Atrial Fibrillation

The CHADS2 score is a validated clinical tool used for the risk stratification of stroke in the presence of atrial fibrillation (AF). Recently, some studies have shown that CHADS2 score may predict the risk of AF, which yielded conflicting results. The purpose of this study is to perform a meta-analysis of observational studies to examine the association between the CHADS2 score and risk of AF. Using PubMed and EMBASE database, we searched published articles by November 2014 to identify studies that evaluated the association between CHADS2 score and the risk of AF. We used both fixed-effects and random-effects models to calculate the overall effect estimate. A sensitivity analysis and subgroup analysis were performed to find the origin of heterogeneity. Of the 1,806 studies identified initially, 19 studies were included into our analysis, with a total of 714,672 patients. The CHADS2 score was found to be an independent predictor of AF as both a continuous variable (odds ratio 1.43, 95% confidence interval 1.10 to 1.86, p = 0.007) and categorical variable (odds ratio 3.37, 95% confidence interval 2.65 to 4.28, p <0.00001). Subgroup analysis revealed that different patients' age in study population may be a possible reason for the significant heterogeneity in our meta-analysis. In conclusion, CHADS2 score predicts the risk of AF. Addressing risk factors and early recognition of AF are important and also awareness of CHADS2 score to reduce stroke risk with pharmacologic prophylaxis.