rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2023-03-05rpcardio-2613Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯEvolution of CHA2DS2-VASc Score for Predicting Risk of Stroke Development in Patients with Atrial FibrillationЭволюция шкалы CHA2DS2-VASc в прогнозировании риска развития инсульта у пациентов с фибрилляцией предсердийhttps://orcid.org/0000-0002-3996-4689РубаненкоА. О.RubanenkoA. O.

Рубаненко Анатолий Олегович,

Самара

Anatoly O. Rubanenko,

Samara

anatolii.rubanenko@gmail.comСамарский государственный медицинский университетРоссияSamara State medical universityRussian Federation202328042023192197202Copyright © Rubanenko A.O., 20232023Рубаненко А.О.Rubanenko A.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/2613

Atrial fibrillation (AF) is associated with dramatic increasing of stroke risk. Development of this serious complication is accompanied by high mortality and disability. Nowadays we know many different scores that predict stroke risk,butthe most popular is CHA2DS2-VASc risk score. At the same time, this score does not have high predictive accuracyand that is why a lot of modifications with inclusion/deletion of different indicators were introduced.

The aim of this review was to estimate the different modifications of CHADS2 и CHA2DS2-VASc scores in predicting stroke risk in patients with AF. In this review R2CHADS2, CHA2DS2-VASc-R, CHA2DS2-VA, mCHA2DS2-VASc and CHA2DS2-VAK scores are evaluated with the use of C-statistics and net reclassification index compared to the original CHA2DS2-VASc score. The search of studies was performed according to PubMed database (https://pubmed.ncbi.nlm.nih.gov/) from 2011 until 2021 years. In this review were included studies written in English with free full text. Literature reviews, books, abstracts books, studies performed on less than 900 patients and studies without C-statistics data available were excluded from this review. Despite of the numerous attempts to improve the quality of CHA2DS2-VASc score, existing modifications nowadays could not become more popular in clinical practice. At the same time, developing of the new score systems, that will have better predictive values in stroke prognosis than CHA2DS2-VASc score, is still an actual problem in modern cardiology. 

Фибрилляция предсердий (ФП) ассоциируется со значительным увеличением риска инсульта. Развитие этого серьезного осложнения сопровождается высокой летальностью и инвалидизацией пациентов. В настоящее время известно большое количество шкал прогнозирования риска инсульта у пациентов с ФП, однако наиболее популярной в клинической практике по-прежнему является шкала CHA2DS2-VASc. В тоже время, данная шкала не обладает высокой предсказательной ценностью, поэтому с целью ее улучшения предпринимаются многочисленные попытки модификаций с включением/удалением различных показателей.

Целью настоящего обзора стала оценка различных модификаций шкал CHADS2 и CHA2DS2-VASc в прогнозировании риска инсульта у пациентов с ФП. В обзоре рассматриваются шкалы R2CHADS2, CHA2DS2-VASc-R, CHA2DS2-VA, mCHA2DS2-VASc, CHA2DS2-VAK, приводится сравнение с оригинальной шкалой CHA2DS2-VASc по значениям С-статистики и индекса реклассификации. Поиск исследований осуществлялся с помощью базы данных PubMed (https://pubmed.ncbi.nlm.nih.gov/) с 2011 по 2021 годы. В обзор включались только те исследования на английском языке, для которых был бесплатно доступен полный текст публикации. В обзор не включались обзоры литературы, книги, сборники тезисов и статей, исследования, выполненные на менее чем 900 пациентах, а также с отсутствием значений С-статистики. Несмотря на многочисленные попытки улучшить шкалу CHA2DS2-VASc, созданные модификации на настоящий момент не смогли уменьшить ее популярность в клинической практике. В тоже время, разработка новых шкал, обладающих более высокой предсказательной ценностью в прогнозировании риска инсульта у пациентов с ФП по-прежнему является актуальной проблемой современной кардиологии. 

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The authors declare that there are no conflicts of interest present.