CHA2DS2-VASc score is a useful-predictor of not prognosis but coronary-arteriosclerosis in chronic atrial-fibrillation compared with CHADS2 score: a two-center study of 320-slice CT, part 2

Background: The aim of this study is to predict the risk of coronary-arteriosclerosis and prognosis in subjects with chronic-atrial-fibrillation (CAF) using the CHADS2 and CHA2DS2-VASc scores by 320-slice-CT and invasive-coronary-angiography (ICA) in a two-center-study.

Methods: 53 CAF subjects who underwent 320-slice-CT and ICA within 6-months (43 male; 69 ± 9 years; CHADS2 score 2.2 ± 1.3; CHA2DS2-VASc score 3.5 ± 1.6) in the two-institutes were analyzed. CT and ICA data were transferred to the analysis-center and were analyzed by cardiologists.

Results: Agatston-calcium-score and frequencies of the presence of various-kinds of plaques and >50% and >75% coronary artery stenosis were significantly higher in the subjects with CHA2DS2-VASc score ≥ 3 compared with those with score <3. However there were no-significant differences in the Agatston-calcium-score and frequencies of the presence of various-kinds of plaques and >50% and >75% coronary artery stenosis evaluated by 320-slice CT between the subjects with CHADS2 score ≥ 2 and <2. Frequency of >50% coronary artery stenosis by ICA was significantly higher in the subjects with CHA2DS2-VASc score ≥ 3 compared with those with score <3. However, there were no-significant differences in the frequencies of >50% and >75% coronary artery stenosis by ICA between the subjects with CHADS2 score ≥ 2 and <2. During a mean of 15.9 months, composite rate of cardiac death and heart failure did not differ between subjects with CHADS2 score ≥ 2 and score <2 and between subjects with CHA2DS2-VASc score ≥ 3 and score <3.

Conclusions: The CHA2DS2-VASc score is a useful predictor of not prognosis but coronary-arteriosclerosis in subjects with CAF compared with CHADS2 score in this two-center-study.