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CHA2DS2-VASc score as a prognostic indicator in patients with atrial fibrillation undergoing coronary stenting

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机构: [1]Peoples Liberat Army Gen Hosp, Div Cardiol & Cardiovasc Surg, Dept Cardiol, Med Ctr 6, Beijing, Peoples R China [2]Chinese Acad Med Sci, Fuwai Hosp, Dept Cardiol, Beijing, Peoples R China [3]Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiol, Beijing, Peoples R China [4]Capital Med Univ, Beijing Tongren Hosp, Dept Cardiol, Beijing, Peoples R China [5]Capital Med Univ, Beijing Friendship Hosp, Dept Cardiol, Beijing, Peoples R China [6]Binzhou Med Univ Hosp, Catheter Lab Cardiovasc & Neurol Intervent, Binzhou, Shandong, Peoples R China
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关键词: Coronary atherosclerotic disease atrial fibrillation percutaneous coronary intervention CHA(2)DS(2)-VASc score prognosis

摘要:
Background/aim: Patients with atrial fibrillation (AF) and coronary stenting had a poor prognosis. This study aimed to assess the accuracy of CHA(2)DS(2)-VASc score for predicting and grading adverse clinical outcomes in this population. Materials and methods: We reviewed the clinical data of all patients with previously documented nonvalvular AF who underwent coronary stenting between January 2010 and June 2015 in 12 hospitals of Beijing, China. The study population was divided into three groups: 1) Low CHA(2)DS(2)-VASc score, <= 2 points, 2) Intermediate score, 3-4 points, and 3) High score, >= 5 points. Major adverse cardiac/cerebrovascular events (MACCE) were defined as a composite of all-cause death, nonfatal myocardial infarction, repeat revascularization and ischemic stroke/systemic thromboembolism (IS/SE). Results: A total of 2394 patients (men: 72.3% vs. women: 27.7%, median age: 67 years) were included, with the CHA(2)DS(2)-VASc score of 3.6 +/- 1.6. The median follow-up duration was 36.2 months. All-cause mortality increased 3 folds from the low score (4.8%) to the high score group (15.8%). The high score group had more IS/SE (7.4%) and MACCE (26.3%). The CHA(2)DS(2)-VASc score >= 5 points was independently associated with all-cause death (hazard ratio [HR]: 2.303, 95% confidence interval [CI]: 1.492-3.555), IS/SE (HR: 4.169, 95% CI: 2.216-7.845) and MACCE (HR: 1.468, 95% CI: 1.113-1.936) on multivariate Cox proportional hazards regression. The area under the receiver operating characteristic curve of the CHA(2)DS(2)-VASc score was 0.644 (95% CI: 0.624-0.663) for all-cause death, 0.647 (95% CI: 0.627-0.666) for IS/SE, and 0.592 (95% CI: 0.572-0.611) for MACCE. Conclusion: CHA(2)DS(2)-VASc score was a reliable prognostic indicator in patients with AF and coronary stenting.

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基金编号: 2019MBD-057 Z151100004015205

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出版当年[2021]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
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出版当年[2020]版:
Q4 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q2 MEDICINE, GENERAL & INTERNAL

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第一作者机构: [1]Peoples Liberat Army Gen Hosp, Div Cardiol & Cardiovasc Surg, Dept Cardiol, Med Ctr 6, Beijing, Peoples R China
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