The CHADS2 and CHA2DS2-VASc scores predict atrial fibrillation in dyslipidemic individuals: Role of incorporating low high-density lipoprotein cholesterol levels.
AIM
To investigate the value of CHADS2 and CHA2DS2-VASc scores in predicting atrial fibrillation (AF) among dyslipidemic individuals and assess the additional value of incorporating low levels of high-density lipoprotein cholesterol (HDL-C).


METHODS
This observational study included 1241 individuals attending a lipid clinic. Models including clinical and laboratory parameters were constructed to test the predictive value of CHADS2 and CHA2DS2-VASc scores as well as low HDL-C levels for incident AF. Low HDL-C levels were defined as <40 and <50mg/dL for male and female subjects, respectively.


RESULTS
After excluding 18 patients with AF at baseline, 1223 subjects were followed-up for a median period of 6years (IQR: 4-10), and 34 (2.8%) developed AF. Baseline CHADS2 (OR: 1.71; 95% CI: 1.28-2.29, p<0.001) and CHA2DS2-VASc scores (OR: 1.56; 95% CI: 1.26-1.92, p<0.001) as well as low HDL-C levels (OR: 3.79; 95% CI: 1.85-7.75, p<0.001) were significantly associated with new-onset AF. ROC curve analyses showed that both CHADS2 and CHA2DS2-VASc scores were significant predictors for new-onset AF (C-Statistic: CHADS2 0.679, p<0.001; CHA2DS2-VASc 0.698, p<0.001). Higher CHADS2 scores were associated with reduced event-free survival from AF (log-rank=10.62, p=0.001) with differences potentiated if stratified by CHA2DS2-VASc score (log-rank=22.29, p<0.001). After incorporating low HDL-C levels, both scores achieved slightly higher C-Statistic for AF prediction (0.690 and 0.707, respectively, p<0.001).


CONCLUSIONS
CHADS2 and CHA2DS2-VASc scores predict new AF in dyslipidemic patients. Risk prediction improved modestly when low HDL-C levels were included.
['Barkas|Fotios|F|', 'Elisaf|Moses|M|', 'Korantzopoulos|Panagiotis|P|', 'Tsiara|Stavroula|S|', 'Liberopoulos|Evangelos|E|']
D000368:Aged D001281:Atrial Fibrillation D050171:Dyslipidemias D005260:Female D005500:Follow-Up Studies D006801:Humans D008075:Lipoproteins, HDL D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D012189:Retrospective Studies D012720:Severity of Illness Index
Atrial fibrillation High-density lipoprotein Cholesterol CHA(2)DS(2)-VASc CHADS(2) Statin