International journal of cardiology · 2018
Atrial fibrillation and prediction of mortality by conventional clinical score systems according to the setting of care.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Diemberger Igor, Fantecchi Elisa, Reggiani Maria Letizia Bacchi, Martignani Cristian, Angeletti Andrea, Massaro Giulia, Ziacchi Matteo, Biffi Mauro, Lip Gregory Y H, Boriani Giuseppe
Аннотация
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 (CHADS2, CHA2DS2-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, who were 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.
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, who were 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.