P2-CHA2DS2-VASc Score

P2-CHA2DS2-VASc Score P2-CHA2DS2-VASc score adds additional two points to the CHA2DS2-VASc score for an abnormal P wave axis to predict risk of stroke in atrial fibrillation (AF) [1]. The seminal study was an attempt to identify utility of P wave indices in sinus rhythm to predict the risk of stroke over and above the existing CHA2DS2-VASc score. P wave indices evaluated were prolonged P wave duration, abnormal P wave axis, advanced interatrial block and abnormal P wave terminal force in lead V1. They found that abnormal P wave axis which is an ECG correlate of left atrial abnormality improves the prediction of ischemic stroke. They concluded that P2-CHA2DS2-VASc score is a better prediction tool for AF related ischemic stroke than CHA2DS2-VASc score. Scoring in P2-CHA2DS2-VASc gives 2 points for abnormal P wave axis, 1 point for age between 65 to 74 years and 2 points for age 75 or more, 1 point each for female sex, heart failure, hypertension, diabetes mellitus and previous myocardial infarction/peripheral artery disease, and 2 points for prevalent stroke or transient ischemic attack. The study used data from two large community based prospective cohort studies for prediction of atrial fibrillation related stroke. The hypothesis was tested in the ARIC (Atherosclerosis Risk in Communities) data [2] and validated in the MESA (Multi-Ethnic Study of Atherosclerosis) data [3]. In the study used for deriving P2-CHA2DS2-VASc score, advanced interatrial block was also independently...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs