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New evidence suggests that the CHA2DS2VASc (congestive heart failure, hypertension [HTN], age, diabetes, stroke, vascular disease, and female gender) score may be a reliable tool to predict the risk of thromboembolic events in patients without documented atrial fibrillation (AF).We performed a prospective cohort study of outpatients without AF or flutter, who were not using oral anticoagulation. Clinical characteristics were assessed and patients were stratified according to the CHA2DS2VASc score. We evaluated the incidence of major adverse cardiac outcomes and its relation to the CHA2DS2VASc score during the follow-up.Four hundred sixty-eight patients without AF were enrolled with a mean follow-up of 12 ± 6 months. Age was 64.9 ± 11.3 years. The prevalence of HTN was 88.4%, diabetes 37.6%, heart failure 26.3%, and vascular disease 61.7%. Overall, CHA2DS2VASc score was 3.4 ± 1.4. There were 15 major adverse cardiac outcomes during 12.2 months of follow-up (overall incidence of 3.2 per 100 person-years). We found significant differences in relation to gender, age, previous stroke, and follow-up length in patients with and without adverse outcomes. The CHA2DS2VASc score was higher in those with adverse outcomes (4.2 ± 1.7 vs 3.4 ± 1.4; P = 0.035). Patients with a CHA2DS2VASc ≥6 had a relative risk for adverse outcomes of 4.2 (95% confidence interval: 1.27–13.90).In our population, CHA2DS2VASc score predicts major adverse cardiac outcomes, including stroke and death, in a cohort of patients without AF.