Prediction of mortality in patients with implantable defibrillator using CHADS2 score: data from a prospective observational investigation

American Journal of Cardiovascular Disease

Domenico Facchin¹  Emanuele Bertaglia²  Giovanni Morani³  Giulio Molon⁴  Gabriele Zanotto⁵  Ermanno Dametto⁶  Giuseppe Allocca⁷  Massimiliano Maines⁸  Sakis Themistoclakis⁹  Franco Zoppo^1,10  Pietro Turrini^1,11 

[1] Azienda Ospedaliera Universitaria Santa Maria della Misericordia, Udine, Italy;Azienda Ospedaliera di Padova, Padova, Italy;Division of Cardiology, Department of Medicine, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy;IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy;Ospedale Mater Salutis, Legnago, Italy;Ospedale Santa Maria degli Angeli, Pordenone, Italy;Ospedale Santa Maria dei Battuti, Conegliano, Italy;Ospedale Santa Maria del Carmine di Rovereto, Italy;Ospedale dellAngelo, Mestre, Italy;ULSS 13 di Mirano, Italy;ULSS 6 Euganea, Camposampiero, Italy

关键词: Implantable cardioverter defibrillator;    CHADS2 score;    atrial fibrillation;    all cause mortality;    prediction of mortality;   

DOI  :  

学科分类：心脏病和心血管学

来源: e-Century Publishing Corporation

【 摘 要 】

Background: CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke/TIA) score has been validated as a risk stratification score to predict stroke in patients with atrial fibrillation (AF). The objective of this analysis was to assess whether patient risk factors, in particular CHADS2 score, identified patients at risk of mortality. Methods: 821 patients with an implantable cardioverter defibrillator were prospectively followed-up in 11 cardiology centers. Patients were grouped in 3 groups according to pre-specified risk classes: low (CHADS2 = 0), moderate (CHADS2 = 1, 2), and high (CHADS2 = 3-6). Information on clinical status and events, were collected during scheduled and unscheduled follow-up visits. Deaths were retrieved from medical records, or through the Regional Office of Vital Statistics. Results: Over a mean follow-up of 44±26 months, 135 deaths occurred in the overall population: 6 (7.7%) in the low-risk population, 69 (13.8%) in moderate-risk patients and 60 (24.6%) in high-risk patients. Kaplan-Meier estimated of patient survival were significantly different in 3 patients groups (93.0%, 90.1%, 78.5% in low, moderate and high risk patients respectively, at 4 years P<0.001). A sub-analysis on patients without history of AF showed similar results. Multivariate regression analysis adjusted for baseline characteristics confirmed the high risk status (HR 1.88, 95% CI 1.27-2.80; P = 0.002) as an independent predictor of mortality adjusted for the baseline characteristics. Conclusions: In our multicenter research, the long-term mortality was higher in patients with high CHADS2 score than in those with lower risk score regardless the presence of history of AF. CHADS2 score could be considered a toll to predict all causes mortality.

【 授权许可】

CC BY-NC