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Olle Melander

Principal investigator

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The co-predictive value of a cardiovascular score for CV outcomes in diabetic patients with no atrial fibrillation


  • Giuseppe Patti
  • Alessandro Sticchi
  • Vincenzo Pasceri
  • Fabrizio Ricci
  • Giulia Renda
  • Viktor Hamrefors
  • Olle Melander
  • Richard Sutton
  • Gunnar Engström
  • Raffaele De Caterina
  • Artur Fedorowski

Summary, in English

Risk factors included in the cardiovascular (CHA2DS2‐VASc) score, currently used for atrial fibrillation (AF), may predispose to cardiovascular events whether or not AF is present. The aim was to explore the predictive role of CHA2DS2‐VASc score on cardiovascular outcomes in diabetic patients without AF.
We accessed individual data from 610 diabetic patients without AF at baseline included in the prospective cohort of the Malmö Diet and Cancer study. Main outcome measure was the occurrence of cardiovascular events (stroke, coronary events) and death. Mean follow‐up was 14.5 ± 5 years (8845 person/years).
The CHA2DS2‐VASc score significantly predicted the risk of all outcome measures. There was a significant increase in stroke, coronary events, and death risk by each point of CHA2DS2‐VASc score elevation [stroke: adjusted hazard ratio (aHR) 1.43, 95% CI 1.14‐1.79, P = 0.001; coronary events: aHR 1.55, 95% CI 1.34‐1.80, P < 0.0001; death: aHR 1.94, 95% CI 1.71‐2.21, P < 0.0001]. A CHA2DS2‐VASc score ≥4 was associated with higher incidence of ischemic stroke (aHR 1.47, 95% CI 1.18‐1.82; P = 0.001), coronary events (aHR 1.32; 95% CI 1.11‐1.58; P = 0.002), and death (aHR 1.36; 95% CI 1.20‐1.54; P < 0.001).
In this population‐based study on diabetic patients without AF, the CHA2DS2‐VASc score was an independent predictor of ischemic stroke, coronary events, and overall mortality. Regardless of the AF status, the CHA2DS2‐VASc score might represent a rapid and user‐friendly tool for clinical assessment of diabetic patients at higher cardiovascular risk.


  • Cardiovascular Research - Hypertension
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health
  • Cardiovascular Research - Epidemiology

Publishing year







Diabetes/Metabolism Research and Reviews





Document type

Journal article


John Wiley and Sons


  • Cardiac and Cardiovascular Systems
  • Endocrinology and Diabetes



Research group

  • Cardiovascular Research - Hypertension
  • Cardiovascular Research - Epidemiology


  • ISSN: 1520-7560