The Risk of Stroke Evaluated by the CHA2DS2-VASc Scale in Patients with Chronic Obstructive Pulmonary Disease and Cardiovascular Comorbidity

| Respiratory
*Ekaterina Kochetova

The author has declared no conflicts of interest.

EMJ Respir. ;5[1]:58-58. Abstract Review No. AR4.

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Chronic obstructive pulmonary disease (COPD), along with other respiratory problems, is accompanied by major cardiovascular comorbid conditions (hypertension, heart failure, atrial fibrillation). The risk of stroke in patients with atrial fibrillation is 5–7-times that of patients with sinus rhythm. Therefore, it is very important to assess the risk of stroke in COPD patients with cardiovascular comorbidities. The CHA2DS2-VASc scale has been used to predict stroke. The abbreviation of the scale name CHA2DS2-VASc is formed from the first letters of the risk factors: Congestive heart failure/left ventricle dysfunction, Hypertension, Age ≥75, Diabetes mellitus, Stroke/transient ischaemic attack/thromboembolism history, Vascular disease, Age 65–74, and Sex (female). Two points or more on the CHA2DS2-VASc scale means a high risk of stroke. It is important to quantify and objectively assess comorbidity. For this purpose, the Charlson Comorbidity Index (CCI) is widely used.


A total of 215 COPD patients were examined. The investigated group comprised patients with a long experience of smoking. In the study group, men predominated (97%) and the average age of patients was 62.21±7.12 years. The risk of stroke was studied by the CHA2DS2-VASc scale.


Among the cardiovascular comorbidities, hypertension predominated (detected in 59% of patients with COPD). Atrial fibrillation was noted in 10.24% of patients. In the group of Stage 2 COPD patients with atrial fibrillation, the mean age was 63.50±7.02 years and the expected stroke rate for the year was 3.50±1.77. In the group of Stage 3–4 COPD patients with atrial fibrillation, the mean age was 66.18±7.05 years, and the expected stroke rate for the year 3.12±0.73. The CCI increased with worsening of the COPD stage.


A significant correlation was found between the stroke rate for the year (percentage measured by CHA2DS2-VASc scale) and the CCI (direct, strong connection; correlation coefficient: 0.89; p<0.005). A direct, strong relationship was established between the expected rate of strokes for the year and the number of cigarette packs smoked per year (correlation coefficient: 0.84; p<0.005).

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