Atrial fibrillation and prediction of mortality by conventional clinical score systems according to the setting of care

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:261

Article

Diemberger, Igor¹  Fantecchi, Elisa²  Reggiani, Maria Letizia Bacchi¹  Martignani, Cristian¹  Angeletti, Andrea¹  Massaro, Giulia¹  Ziacchi, Matteo¹  Biffi, Mauro¹  Lip, Gregory Y. H.³  Boriani, Giuseppe² 

[1] Univ Bologna, Policlin S Orsola Malpighi, Dept Expt Diagnost & Specialty Med, Inst Cardiol, Via Massarenti 9, I-40138 Bologna, Italy

[2] Univ Modena & Reggio Emilia, Policlin Modena, Dept Diagnost Clin & Publ Hlth Med, Div Cardiol, Modena, Italy

[3] Univ Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, England

关键词: Outcomes;    Real world;    Registry;    Survival;    Arrhythmia;   

DOI  :  10.1016/j.ijcard.2018.03.058

来源: Elsevier

【 摘 要 】

Background: Atrial fibrillation (AF) is associated with high morbidity and mortality, also among anticoagulated patients. Our aim was to evaluate the predictive role for long-term mortality of a series of risk stratification scores associated with cardiovascular or thromboembolic outcomes (CHADS(2), CHA(2)DS(2)-VASc, ATRIA, TIMI-AF), and bleeding complications (HAS-BLED) in an unselected population of patients with AF. Methods: Single center, observational, prospective registry of consecutive patients with AF, undergoing clinical/echocardiographic evaluation in a University Hospital, as either in-patients or out-patients. We assessed the role of each single score as predictors of long-term survival according to clinical setting. Results: We enrolled 1051 patients, mean age 72 +/- 12 years, whowere followed for 797 +/- 298 days. All the tested scores showed a good performance in prediction of mortality, together with several clinical factors (older age, chronic heart failure, diabetes, renal impairment, previous transient ischemic attack, left ventricular ejection fraction). The values at C-statistics ranged between modest (0.608-0.684) of inpatients to good (0.708-0.751) in outpatients without any statistical difference between the scores, excepted a lower performance of HAD-BLED. Conclusions: Risk scores currently adopted for decision making on starting oral anticoagulation provide good prediction of long-term survival in unselected AF patients, especially in the outpatient setting. (c) 2017 Published by Elsevier B.V.

【 授权许可】

Free