INTRODUCTION AND OBJECTIVES: The risk of stroke in atrial fibrillation is heterogeneous and depends upon underlying clinical conditions included in current risk stratification schemes. Recently, the CHA(2)DS(2)-VASc score has been included in guidelines to be more inclusive of common stroke risk factors seen in everyday clinical practice, and useful in defining "truly low risk" subjects. We aimed to assess the usefulness of CHA(2)DS(2)-VASc score to give us an additional prognostic perspective for adverse events and mortality among "real world" anticoagulated patients with atrial fibrillation who are often elderly with many comorbidities. METHODS: Consecutive outpatients with permanent/paroxysmal nonvalvular atrial fibrillation with CHA(2)DS(2)-VASc≥2 and stabilized oral anticoagulation (international normalized ratio 2.0-3.0) for at least the preceding 6 months were recruited. Patients with CHA(2)DS(2)-VASc≥2 were selected. Adverse cardiovascular events including stroke, acute coronary syndrome, or heart failure; major bleeds; and mortality were recorded during more than 2.5-year-follow-up. RESULTS: Of 933 patients (93.5%) assessed, 432 were males, median age 76 (71-81) years. After a follow-up of 946 (782-1068) days, 109 patients (11.7%) had adverse cardiovascular events, 80 patients (8.6%) had major bleeds, 101 patients (10.8%) died, and 230 (24.6%) had major adverse events (composite end-point). Increasing CHA(2)DS(2)-VASc score by 1 point had a significant impact on the occurrence of cardiovascular events (hazard ratio=1.27; 95% confidence interval, 1.13-1.44; P<.001), mortality (hazard ratio=1.36; 95% confidence interval, 1.19-1.54; P<.001); and major adverse events (hazard ratio=1.23; 95% confidence interval, 1.13-1.34; P<.001). CHA(2)DS(2)-VASc score was not associated with major bleeding episodes. CONCLUSIONS: Among high risk atrial fibrillation patients on oral anticoagulation, CHA(2)DS(2)-VASc successfully predicts cardiovascular events and mortality, but not major bleeds.
INTRODUCTION AND OBJECTIVES: The risk of stroke in atrial fibrillation is heterogeneous and depends upon underlying clinical conditions included in current risk stratification schemes. Recently, the CHA(2)DS(2)-VASc score has been included in guidelines to be more inclusive of common stroke risk factors seen in everyday clinical practice, and useful in defining "truly low risk" subjects. We aimed to assess the usefulness of CHA(2)DS(2)-VASc score to give us an additional prognostic perspective for adverse events and mortality among "real world" anticoagulated patients with atrial fibrillation who are often elderly with many comorbidities. METHODS: Consecutive outpatients with permanent/paroxysmal nonvalvular atrial fibrillation with CHA(2)DS(2)-VASc≥2 and stabilized oral anticoagulation (international normalized ratio 2.0-3.0) for at least the preceding 6 months were recruited. Patients with CHA(2)DS(2)-VASc≥2 were selected. Adverse cardiovascular events including stroke, acute coronary syndrome, or heart failure; major bleeds; and mortality were recorded during more than 2.5-year-follow-up. RESULTS: Of 933 patients (93.5%) assessed, 432 were males, median age 76 (71-81) years. After a follow-up of 946 (782-1068) days, 109 patients (11.7%) had adverse cardiovascular events, 80 patients (8.6%) had major bleeds, 101 patients (10.8%) died, and 230 (24.6%) had major adverse events (composite end-point). Increasing CHA(2)DS(2)-VASc score by 1 point had a significant impact on the occurrence of cardiovascular events (hazard ratio=1.27; 95% confidence interval, 1.13-1.44; P<.001), mortality (hazard ratio=1.36; 95% confidence interval, 1.19-1.54; P<.001); and major adverse events (hazard ratio=1.23; 95% confidence interval, 1.13-1.34; P<.001). CHA(2)DS(2)-VASc score was not associated with major bleeding episodes. CONCLUSIONS: Among high risk atrial fibrillationpatients on oral anticoagulation, CHA(2)DS(2)-VASc successfully predicts cardiovascular events and mortality, but not major bleeds.
Authors: Beata Uziębło-Życzkowska; Paweł Krzesiński; Agnieszka Jurek; Monika Budnik; Iwona Gorczyca; Agnieszka Kapłon-Cieślicka; Marek Kiliszek; Agnieszka Wójcik; Monika Gawałko; Olga Jelonek; Anna Michalska; Katarzyna Starzyk; Piotr Scisło; Janusz Kochanowski; Krzysztof J Filipiak; Beata Wożakowska-Kapłon; Grzegorz Opolski; Grzegorz Gielerak Journal: Cardiovasc Diagn Ther Date: 2020-08
Authors: Jose Luis Clua-Espuny; Anna Panisello-Tafalla; Carlos Lopez-Pablo; Inigo Lechuga-Duran; Ramon Bosch-Princep; Jorgina Lucas-Noll; Antonia Gonzalez-Henares; Lluisa Queralt-Tomas; Rosa Ripolles-Vicente; Cristina Calduch-Noll; Nuria Gonzalez-Rojas; Miguel Gallofre-Lopez Journal: Cardiol Res Date: 2014-02-27
Authors: Jin Man Jung; Yong Hyun Kim; Sungwook Yu; Kyungmi O; Chi Kyung Kim; Tae Jin Song; Yong Jae Kim; Bum Joon Kim; Sung Hyuk Heo; Kwang Yeol Park; Jeong Min Kim; Jong Ho Park; Jay Chol Choi; Man Seok Park; Joon Tae Kim; Kang Ho Choi; Yang Ha Hwang; Jong Won Chung; Oh Young Bang; Gyeong Moon Kim; Woo Keun Seo Journal: J Clin Neurol Date: 2019-10 Impact factor: 3.077
Authors: Jose Luis Clua-Espuny; Rosa Ripolles-Vicente; Carlos Lopez-Pablo; Anna Panisello-Tafalla; Jorgina Lucas-Noll; Cristina Calduch-Noll; M Antonia González-Henares; M Lluisa Queralt-Tomas Journal: Aten Primaria Date: 2014-06-19 Impact factor: 1.137
Authors: Gregory Y H Lip; Sana M Al-Khatib; Francisco G Cosio; Amitava Banerjee; Irina Savelieva; Jeremy Ruskin; Dan Blendea; Stanley Nattel; Joseph De Bono; Jennifer M Conroy; Paul L Hess; Eduard Guasch; Jonathan L Halperin; Paulus Kirchhof; M Dolores G Cosio; A John Camm Journal: J Am Heart Assoc Date: 2014-08-27 Impact factor: 5.501