Comparison of CHADS-VASc, CHADS and HATCH scores for the prediction of new-onset atrial fibrillation in cancer patients: A nationwide cohort study of 760,339 study participants with competing risk analysis.

BACKGROUND AND AIMS

The current study was conducted to assess the ability of CHADS-VASc, CHADS and HATCH scores in predicting new-onset atrial fibrillation (AF) among patients with cancer.

METHODS

Patients with newly diagnosed cancer between 1 January, 2000 and 31 December, 2011, from the Registry for Catastrophic Illness Patient Database, were defined as the study cohort. CHADS-VASc, CHADS and HATCH scores were used for new-onset AF prediction in these study patients, and the predictive accuracy of the scores was assessed by the receiver operating characteristics (ROC) curve.

RESULTS

A total of 760,339 cancer patients were identified as the study participants. The ROC curves were 0.68 (95% confidence interval [CI] = 0.68-0.69) for the CHADS-VASc score, 0.67 (95% CI = 0.67-0.68) for the CHADS score and 0.69 (95% CI = 0.69-0.70) for the HATCH score. There were significant differences of c-statistics among CHADS-VASc score, CHADS score and HATCH score (CHADS-VASc score vs. CHADS score, p = 0.01; CHADS-VASc score vs. HATCH score, p = 0.002; CHADS score vs. HATCH score, p < 0.001).

CONCLUSIONS

The current study is the first to assess the prognostic value of 3 AF risk scores (CHADS-VASc, CHADS and HATCH scores) in patients with newly-diagnosed cancer. HATCH score was found to have a slightly but significantly better predictive performance than the other 2 scores.