Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang Hebei 050000, China; Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China.
Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China.
Am J Cardiol. 2020 Aug 15;129:30-35. doi: 10.1016/j.amjcard.2020.05.035. Epub 2020 Jun 3.
The association between CHADS2 score and stroke has been confirmed in patients with atrial fibrillation. But the majority of cardiovascular events occurred primarily in population without atrial fibrillation. Therefore, we performed this cohort study to evaluate the association between baseline CHADS2 score and cardiovascular events in the population without atrial fibrillation. A total of 99,755 Chinese adults with complete baseline data were followed for up to 10 years. The primary outcomes were cardiovascular event (a composite endpoint of myocardial infarction, cerebral infarction, and cerebral hemorrhage) and all-cause death. The area under the receiver operating characteristic curve was calculated for each kind of outcome. The adjusted cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals. The results showed the incidence of cardiovascular events and all-cause death increased with CHADS2 score. The area under the receiver operating characteristic curve for myocardial infarction, cerebral infarction, cerebral hemorrhage, cardiovascular events and all-cause death was 0.66, 0.67, 0.66, 0.67, and 0.69, respectively in participants without atrial fibrillation. Each 1 point increase in CHADS2 score was associated with the risk of all the outcomes in participants without atrial fibrillation after adjusting for age, sex, and other conventional cardiovascular confounders, the hazard ratio (95% confidence interval) for cardiovascular event and all-cause death was 1.17 (1.13 to 1.22) and 1.12 (1.08 to 1.15), respectively. In conclusion, baseline CHADS2 score is an independent risk factor for cardiovascular events and all-cause death in the population without atrial fibrillation.
CHADS2 评分与房颤患者中风之间的关联已得到证实。但大多数心血管事件主要发生在无房颤人群中。因此,我们进行了这项队列研究,以评估无房颤人群中基线 CHADS2 评分与心血管事件之间的关系。共有 99755 名中国成年人有完整的基线数据,随访时间长达 10 年。主要结局是心血管事件(心肌梗死、脑梗死和脑出血的复合终点)和全因死亡。计算了每种结局的接受者操作特征曲线下面积。使用调整后的 Cox 比例风险模型来估计风险比和 95%置信区间。结果表明,心血管事件和全因死亡率随着 CHADS2 评分的增加而增加。在无房颤患者中,心肌梗死、脑梗死、脑出血、心血管事件和全因死亡的接受者操作特征曲线下面积分别为 0.66、0.67、0.66、0.67 和 0.69。在调整年龄、性别和其他常规心血管混杂因素后,CHADS2 评分每增加 1 分,与无房颤患者所有结局的风险相关,心血管事件和全因死亡的风险比(95%置信区间)分别为 1.17(1.13 至 1.22)和 1.12(1.08 至 1.15)。总之,基线 CHADS2 评分是无房颤人群中心血管事件和全因死亡的独立危险因素。