Baseline CHADS2 Score and Risk of Cardiovascular Events in the Population Without Atrial Fibrillation

Abstract The association between CHADS2 score and stroke has been confirmed in patients with atrial fibrillation. But the majority of cardiovascular events occurred primarily in population without atrial fibrillation. Therefore, we performed this cohort study to evaluate the association between baseline CHADS2 score and cardiovascular events in the population without atrial fibrillation. A total of 99,755 Chinese adults with complete baseline data were followed for up to 10 years. The primary outcomes were cardiovascular event (a composite endpoint of myocardial infarction, cerebral infarction and cerebral hemorrhage) and all-cause death. The area under the receiver operating characteristic curve was calculated for each kind of outcome. The adjusted cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals. The results showed the incidence of cardiovascular events and all-cause death increased with CHADS2 score. The area under the receiver operating characteristic curve for myocardial infarction, cerebral infarction, cerebral hemorrhage, cardiovascular events and all-cause death was 0.66, 0.67, 0.66, 0.67 and 0.69, respectively in participants without atrial fibrillation. Each 1 point increase in CHADS2 score was associated with the risk of all the outcomes in participants without atrial fibrillation after adjusting for age, sex, and other conventional cardiovascular confounders, the hazard ratio (95% confidence interval) for cardiovascular event and all-cause death was 1.17(1.13-1.22) and 1.12(1.08-1.15), respectively. In conclusion, baseline CHADS2 score is an independent risk factor for cardiovascular events and all-cause death in the population without atrial fibrillation.