Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
J Am Coll Cardiol. 2011 Nov 29;58(23):2380-5. doi: 10.1016/j.jacc.2011.08.045.
This study aimed to evaluate whether CHADS(2) and CHA(2)DS(2)-VASc scores are useful for risk stratification in patients after catheter ablation of atrial fibrillation (AF).
AF is associated with increased risk of cardiovascular events. However, limited data are available on the predictors of adverse events in patients with AF after catheter ablation.
A total of 565 patients with AF who underwent catheter ablation were enrolled in the study. The clinical endpoint was occurrence of thromboembolic events (ischemic stroke, transient ischemic attack, peripheral embolism, or pulmonary embolisms) or death during follow-up after catheter ablation.
During a follow-up of 39.2 ± 22.6 months, 27 patients (4.8%) experienced adverse events. Both the CHADS(2) and CHA(2)DS(2)-VASc scores were useful predictors of events in separate multivariate models. The areas under the receiver-operator characteristic curves based on the CHADS(2) and CHA(2)DS(2)-VASc scores in predicting events were 0.785 and 0.830, respectively. Although the difference did not reach statistical significance (p = 0.116), the CHA(2)DS(2)-VASc score could be used to further stratify the patients with CHADS(2) scores of 0 or 1 into 2 groups with different event rates (7.1% vs. 1.1%, p = 0.003) at a cutoff value of 2.
The CHADS(2) and CHA(2)DS(2)-VASc scores are useful predictors of adverse events after catheter ablation of AF.
本研究旨在评估 CHADS₂ 和 CHA₂DS₂-VASc 评分在房颤（AF）导管消融后患者的风险分层中的作用。
AF 与心血管事件风险增加相关。然而，关于 AF 导管消融后患者不良事件的预测因素的数据有限。
共纳入 565 例接受导管消融的 AF 患者。临床终点是导管消融后随访期间发生血栓栓塞事件（缺血性卒、短暂性脑缺血发作、外周栓塞或肺栓塞）或死亡。
在 39.2±22.6 个月的随访期间，27 例（4.8%）发生不良事件。CHADS₂ 和 CHA₂DS₂-VASc 评分在单独的多变量模型中都是事件的有用预测指标。基于 CHADS₂ 和 CHA₂DS₂-VASc 评分预测事件的受试者工作特征曲线下面积分别为 0.785 和 0.830。虽然差异没有达到统计学意义（p=0.116），但 CHA₂DS₂-VASc 评分可以进一步将 CHADS₂ 评分为 0 或 1 的患者分为两组，两组的事件发生率不同（7.1% vs. 1.1%，p=0.003），截断值为 2。
CHADS₂ 和 CHA₂DS₂-VASc 评分是 AF 导管消融后不良事件的有用预测指标。
