Vascular Health and Risk Management (Apr 2023)

Validation of CHA2DS2 VASc Score Predictability of Stroke and Systemic Embolization in a Middle Eastern Population with AF: The Jordan Atrial Fibrillation (JoFib) Study

  • Ibdah R,
  • Obeidat O,
  • Khader Y,
  • Al-Nusair J,
  • Abusurrah O,
  • Obeidat A,
  • Obeidat A,
  • Rawashdeh S,
  • Alrabadi N,
  • Obiedat AF,
  • Alnadi NN,
  • Hammoudeh A

Journal volume & issue
Vol. Volume 19
pp. 255 – 264

Abstract

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Rasheed Ibdah,1,* Omar Obeidat,1,* Yousef Khader,2 Jowan Al-Nusair,1 Obada Abusurrah,1 Abedallah Obeidat,1 Ali Obeidat,1 Sukaina Rawashdeh,1 Nasr Alrabadi,3 Abdelrahman F Obiedat,4 Naseem N Alnadi,4 Ayman Hammoudeh4 1Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan; 3Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 4Department of Cardiology, Istishari Hospital, Amman, Jordan*These authors contributed equally to this workCorrespondence: Rasheed Ibdah, Division of Cardiology, Department of Internal Medicine, Jordan University for Science and Technology, Irbid, 22110, Jordan, Email [email protected] and Purpose: CHA2DS2-VASc score is one of the most widely used scoring systems to assess the risk of systemic embolization and stroke in patients suffering from atrial fibrillation (Afib); furthermore, it is important in guiding their treatment. This study aimed to evaluate the predictivity of this score in the Jordanian population, build a deeper understanding of patients’ demographic and risk factors, and assess the usefulness of anticoagulation as a preventive measure.Methods: A total of 2020 patients with Afib registered in the Jordanian Atrial Fibrillation (JoFib) registry were enrolled in this study. All patients were followed up for 1 year to assess their susceptibility to develop cerebrovascular accident (CVA) and systemic embolism (SE). The association between CHA2DS2-VASc score and risk of development of stroke or systemic embolization was analyzed based on bivariate and adjusted multivariate analyses. The ROC curve was used to assess the predictivity of the CHA2DS2-VASc score.Results: The mean age of the study population was 67.8 years; 45.8% were males, and 81.8% were on anticoagulants. And, 71.8% had a CHA2DS2-VASc score of ≥ 3. During the follow-up period of 1 year; 69 developed new CVA (mean age, 72.8 years), and 9 developed SE. A total of 276 patients died; 18 patients died (6.5% out of all deceased)% from CVA. A moderate predictive power of the CHA2DS2-VASc score was demonstrated through ROC curve analysis with C statistics of 0.689 CI (0.634 to 0.744) for predicting the development of SE or CVA at 1 year.Conclusion: CHA2DS2-VASc showed a moderate predictivity of stroke, SE, and all-cause mortality at 1 year. The study suggested disregarding gender differences in deciding to initiate anticoagulant therapy.Keywords: atrial fibrillation, Jordan, CHA2DS2-VASc, stroke, risk

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