Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Stroke in patients with non-valvular AF is a major cause for disability and increasing morbidity and
mortality, CHA2DS2-VASc is a tool for assessing the risk of stroke in these patients
OBJECTIVE:
This study was conducted to evaluate the use of CHA2DS2-VASc scoring system in a sample of Iraqi
patients with embolic stroke and non valvular atrial fibrillation
PATIENTS AND METHODS:
A cross-sectional study was done in Baghdad Teaching Hospital that enrolled 60 patients with nonvalvular
atrial fibrillation who presented with a first-time ischemic stroke. Data was collected using
a questionnaire, CHA2DS2-VASc score was calculated (excluding 2 points of stroke for all
patients), and also HAS-BLED score was calculated.
RESULTS:
In this study, there was a statistically significant association between age groups and CHA2DS2-
VASc scores, as most patients with low scores were in younger age groups and most of patients with
higher scores were in older age groups. The same association was found between sex and CHA2DS2-
VASc scores, noting that the majority of the study group were females (70.0%). The most frequent
risk factor was hypertension which was diagnosed in (85.0%) of the study group, followed by heart
failure (51.7%), and diabetes mellitus (40.0%), while the presence of vascular diseases was the least
common (26.7%). Warfarin use was recorded in only 7(11.7%) patients. There was no statistically
significant association between CHA2DS2-VASc and HAS-BLED scores.
CONCLUSION:
CHA2DS2-VASc was a valuable tool for assessing risk of embolic stroke, yet, there was a low
frequency of anticoagulation use which was not explained by HAS-BLED scores. Hypertension and
heart failure were the most common among study group, followed by diabetes mellitus.