Introduction: T he CHADS2, CHA₂DS₂-VASc and R2CHADS2 scores are well-known predictors of stroke in patients with atrial fibrillation. Due to the inclusion of major cardio-vascular comorbidities, they could po-tentially be useful in stratifying all-cause mortality in patients with heart failure (HF).
Aim: Our objective is to assess the predictive value of these scores for all-cause long-term HF mortality. Methods: We retrospectively included HF patients ad-mitted from January 2012 to December 2014. Patients with in-hospital mortality, acute coronary syndromes, pulmonary embolisms, neoplasms and systemic infec-tions were excluded. Survival was assessed on June 1st 2018.
Results: The study group consisted of 726 patients with HF, 53.72% women, with a mean age of 71.57±10.44 years. Long-term (5 years) mortality was 41.31%.
In the entire sample, in ROC curve analysis, R2CHA-DS2 score predicted mortality with an AUC of 0.640 (95%CI 0.598-0.683), p<0.001, CHA₂DS₂-VASc with an AUC of 0.547 (95%CI 0.504-0.590), p=0.036, and CHADS2 with an AUC of 0.547 (95%CI 0.540-0.626), p<0.001.
Best correlation of mortality percentages to score va-riability was obtained for the R2CHADS2 score. Mor-tality increased with each point of the score from 28% in patients with a score of 1 or 2, 30% in those with a score of 3, 50% in those with a score of 5, 57.89% in those with a score of 6 and 51.85% in those with a score of 7 or 8, p for trend <0.001.
Regardless of the presence of atrial fibrillation, the three scores remained predictors of long-term all-cause mortality.
Conclusions: T he CHADS2, CHA₂DS₂-VASc and R2CHADS2 scores are viable predictors of long-term all-cause mortality in heart failure patients. Of the three scores, R2CHADS2 has the best prognostic accuracy.