Ziqiong Wang1, Hang Liao1, Sen He2, Xiaoping Chen3. 1. Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. 2. Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. Electronic address: cc1990310@qq.com. 3. Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China. Electronic address: xiaopingchen0310@163.com.
Abstract
OBJECTIVE: To validate the modified R-CHA2DS2VASc score as a predictor of thromboembolism in HCM patients. METHODS: A total of 446 HCM patients were enrolled in our study, thirty-one (6.95%) patients experienced thromboembolic events during the follow-up time of 1786.7 person-years. The association between R-CHA2DS2VASc score and risk of thromboembolism was assessed by Cox's proportional hazard analysis. The discriminatory power of R-CHA2DS2VASc score for thromboembolism prediction was assessed by Harrell's C-statistic and validated internally by bootstrapping methods. Calibration plot was plotted by observed versus expected probabilities of thromboembolism. RESULTS: The R-CHA2DS2VASc score was well calibrated with 0.84 thromboembolic events per 100 person-years in the predefined low risk (R-CHA2DS2VASc score ≤2) group, 1.84 in the low to moderate risk (R-CHA2DS2VASc score 3-4) group, 4.67 in the moderate to high risk (R-CHA2DS2VASc score 5-7) group, and 17.54 in the high risk (R-CHA2DS2VASc score ≥8) group. Hazard ratios for thromboembolism were 2.88 (95%CI: 1.06-7.82, P=0.038) for low to moderate versus low risk group, 5.30 (95%CI: 2.14-13.12, P=0.0003) for moderate to high versus low risk group, and 16.57 5.30 (95%CI: 4.96-55.33, P<0.0001) for high versus low risk group after adjusting left atria size. The Harrell's C statistic was 0.7737 (95% CI: 0.65-0.89) for R-CHA2DS2VASc score. CONCLUSION: The R-CHA2DS2VASc score has shown good calibration and discriminative power in the prediction of thromboembolism for HCM patients. It should be considered as a potential decision support tool for HCM patients during clinical practice.
OBJECTIVE: To validate the modified R-CHA2DS2VASc score as a predictor of thromboembolism in HCM patients. METHODS: A total of 446 HCM patients were enrolled in our study, thirty-one (6.95%) patients experienced thromboembolic events during the follow-up time of 1786.7 person-years. The association between R-CHA2DS2VASc score and risk of thromboembolism was assessed by Cox's proportional hazard analysis. The discriminatory power of R-CHA2DS2VASc score for thromboembolism prediction was assessed by Harrell's C-statistic and validated internally by bootstrapping methods. Calibration plot was plotted by observed versus expected probabilities of thromboembolism. RESULTS: The R-CHA2DS2VASc score was well calibrated with 0.84 thromboembolic events per 100 person-years in the predefined low risk (R-CHA2DS2VASc score ≤2) group, 1.84 in the low to moderate risk (R-CHA2DS2VASc score 3-4) group, 4.67 in the moderate to high risk (R-CHA2DS2VASc score 5-7) group, and 17.54 in the high risk (R-CHA2DS2VASc score ≥8) group. Hazard ratios for thromboembolism were 2.88 (95%CI: 1.06-7.82, P=0.038) for low to moderate versus low risk group, 5.30 (95%CI: 2.14-13.12, P=0.0003) for moderate to high versus low risk group, and 16.57 5.30 (95%CI: 4.96-55.33, P<0.0001) for high versus low risk group after adjusting left atria size. The Harrell's C statistic was 0.7737 (95% CI: 0.65-0.89) for R-CHA2DS2VASc score. CONCLUSION: The R-CHA2DS2VASc score has shown good calibration and discriminative power in the prediction of thromboembolism for HCM patients. It should be considered as a potential decision support tool for HCM patients during clinical practice.