The CHADS2 score is a useful predictor of coronary arteriosclerosis on 320 slice CT and may correlate with prognosis in subjects with atrial fibrillation

Abstract

PurposeIn evaluating coronary arteries by 64–256 slice CT, atrial fibrillation (AF) is usually an exclusion criterion. We used CHADS2 score to predict coronary arteriosclerosis estimated by 320-slice CT and prognosis in AF subjects. MethodsA total of 183 consecutive subjects (148 male; 64.1±11.1years, 97 hypertension, 60 hyperlipidemia, 21 diabetes mellitus, 76 smoking habits, body mass index 23.4±3.5) who were diagnosed previously as chronic (N=104) or paroxysmal AF (N=79), and who underwent electrocardiogram-gated 320-slice CT were enrolled. The composite end point of cardiac death or sudden death was assessed. ResultsA total of 183 AF subjects were divided into 3 groups: CHADS2 scores of 0 (N=53), 1 (N=57) and ≥2 (N=73). Frequency of the presence of calcified plaque, non-calcified plaque, mixed plaque, any plaque, and >50% stenosis and Agatston calcium score was significantly lower in CHADS2 score 0 group compared with score 1 or score≥2 groups. In logistic-regression models for prediction of calcified plaque, or any plaque on CT, the odds ratios of CHADS2 score≥2 group to CHADS2 score 0 or 1 group were 2.03 and 2.12, respectively (both P<0.05). During a median of 19.2months, the composite-event-rate was significantly higher in subjects with CHADS2 score≥2 than those with CHADS2 score 0 (P=0.049) in Kaplan–Meier survival analysis. ConclusionsThe CHADS2 score is a useful predictor of coronary arteriosclerosis on CT and may correlate with prognosis in AF subjects. Subjects with high CHADS2 score should be examined for coronary arteriosclerosis in addition to cerebral infarction.