Incremental value of estimated glomerular filtration rate in improving stroke risk stratification in patients with and without atrial fibrillation considered to be low risk by CHA2DS2VASc score

BACKGROUND: CHA 2 DS 2 VASc scoring system is a useful clinical tool to characterize stroke risk in patients with and without atrial Fibrillation (AF), yet thromboembolic complications occur in patients deemed low risk for stroke (0-1 score for AF and 0-3 score for non-AF patients). We hypothesized that incorporating information about renal dysfunction will improve risk stratification of patients with CHA 2DS 2 VASc score of 0 to 3. METHODS: Consecutive patients with or without AF evaluated at a large community based academic medical center from 2012 to 2015 were identified and those with a CHA 2 DS 2 VASc Score of 0-3 assessed for incident stroke. Based on estimated glomerular filtration rate (eGFR) relative improvement in risk stratification of stroke in AF and non-AF patients were determined using cochrane armitage test. RESULTS: The overall proportion of stroke over 3 years mean follow-up in patients with or without AF with baseline CHA 2 DS 2 VASc score 0-3 with eGFR and improvement in risk stratification is summarized in Table. CONCLUSIONS: In patients considered low risk by CHA 2 DS 2 VASc score, incorporating eGFR information improves risk stratification and decision for anticoagulation. Open full size imag