Sciacqua Angela, Perticone Maria, Tripepi Giovanni, Tassone Eliezer J, Cimellaro Antonio, Mazzaferro Deborah, Sesti Giorgio, Perticone Francesco
Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy.
Department of Clinical and Experimental Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Intern Emerg Med. 2015 Oct;10(7):815-21. doi: 10.1007/s11739-015-1243-3. Epub 2015 May 5.
No data exist concerning a possible association between CHADS2 or CHA2DS2-VASc scores and atrial fibrillation (AF). In this prospective observational study, we tested the hypothesis whether thromboembolic risk scores predict AF. We investigated 3549 subjects, 1829 men and 1720 women, aged 60.7 ± 10.6 years, without baseline AF. Patients with thyroid disorders were excluded. CHADS2 and CHA2DS2-VASc scores were evaluated as categorical variables. To test the effect of some clinical confounders on incident AF, we constructed different models including clinical and laboratory parameters. During follow-up (53.3 ± 18.1 months), 546 subjects developed AF (4.5 events/100 patient-years). Progressors to AF are older, have a higher body mass index (BMI), blood pressure, LDL-cholesterol, and glucose. Hypertension, metabolic syndrome, diabetes and carotid wall thickening were more common among AF cases than among control subjects. In the final Cox-regression model, variables that remained significantly associated with incident AF were BMI (HR = 1.022, 95% CI = 1.008-1.037), LDL-cholesterol (HR = 1.032, 95% CI = 1.008-1.056), CHA2DS2-VASc score (HR = 1.914, 95% CI = 1.439-2.546), and CHADS2 score (HR = 2.077, 95% CI = 1.712-2.521). In conclusion, CHADS2 and CHA2DS2-VASc scores are independent predictors of AF.
目前尚无关于CHADS2或CHA2DS2-VASc评分与心房颤动(AF)之间可能存在关联的数据。在这项前瞻性观察性研究中,我们检验了血栓栓塞风险评分是否能预测AF这一假设。我们调查了3549名受试者,其中男性1829名,女性1720名,年龄为60.7±10.6岁,均无基线AF。排除患有甲状腺疾病的患者。将CHADS2和CHA2DS2-VASc评分作为分类变量进行评估。为了检验一些临床混杂因素对新发AF的影响,我们构建了包括临床和实验室参数的不同模型。在随访期间(53.3±18.1个月),546名受试者发生了AF(4.5例事件/100患者年)。发生AF的患者年龄更大,体重指数(BMI)、血压、低密度脂蛋白胆固醇和血糖更高。高血压、代谢综合征、糖尿病和颈动脉壁增厚在AF病例中比在对照受试者中更常见。在最终的Cox回归模型中,与新发AF仍显著相关的变量有BMI(HR = 1.022,95%CI = 1.008 - 1.037)、低密度脂蛋白胆固醇(HR = 1.032,95%CI = 1.008 - 1.056)、CHA2DS2-VASc评分(HR = 1.914,95%CI = 1.439 - 2.546)和CHADS2评分(HR = 2.077,95%CI = 1.712 - 2.521)。总之,CHADS2和CHA2DS2-VASc评分是AF的独立预测因素。