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ATRIA 卒中风险评分在预测心房高频事件中的价值:六种不同风险评分的比较。

Value of ATRIA stroke risk score in predicting atrial high-rate episodes: A comparison of six different risk scores.

机构信息

Department of Cardiology, Kafkas University Faculty of Medicine, Kars, Turkey.

Department of Cardiology, Kars Harakani State Hospital, Kars, Turkey.

出版信息

Pacing Clin Electrophysiol. 2023 Aug;46(8):978-985. doi: 10.1111/pace.14749. Epub 2023 Jun 7.

DOI:10.1111/pace.14749
PMID:37283495
Abstract

OBJECTIVES

Atrial high-rate episodes (AHRE) are asymptomatic atrial tachy-arrhythmias detected through continuous monitoring with a cardiac implantable electronic device (CIED). AHRE's have been associated with increased risks of developing clinically manifested atrial fibrillation (AF), thromboembolism, cardiovascular events, and mortality. Several variables has been researched and identified to predict AHRE development. The aim of this study, which compared the six frequently-used scoring systems for thromboembolic risk in AF (CHA DS -VASc, mC HEST, HAT CH , R -CHADS , R -CHA DS -VASc, and ATRIA) in terms of their prognostic power in predicting AHRE.

MATERIALS AND METHODS

This retrospective study included 174 patients with CIED's. The study population was divided into two groups according to presence of AHRE: patients with AHRE (+) and patients without AHRE (-). Thereafter, patients baseline characteristics and scoring systems were analyzed for prediction of AHRE.

RESULTS

The distribution of patients' baseline characteristics and scoring systems according to presence of AHRE was evaluated. Furthermore, ROC curve analyses of the stroke risk scoring systems have been investigated in terms of predicting the development of AHREs. ATRIA, which predicted AHRE with a specificity of 92% and sensitivity of 37.5% for ATRIA values of >6, performed better than other scoring systems in predicting AHRE (AUC: 0.700, 0.626-0.767 95% confidence interval (CI), p = .004) CONCLUSION: AHRE is common in patients with a CIED. In this context, several risk scoring systems have been used to predict the development of AHRE in patients with a CIED. This study's findings revealed that The ATRIA stroke risk scoring system performed better than other commonly used risk scoring systems in predicting AHRE.

摘要

目的

心房高频事件(AHRE)是通过心脏植入式电子设备(CIED)进行连续监测检测到的无症状性房性心动过速-心律失常。AHRE 与发展为临床显性心房颤动(AF)、血栓栓塞、心血管事件和死亡的风险增加相关。已经研究并确定了几种变量来预测 AHRE 的发展。本研究比较了六种常用于 AF 血栓栓塞风险的评分系统(CHA2DS2-VASc、mCHEST、HAT-CH、R-CHADS、R-CHADS2-VASc 和 ATRIA)在预测 AHRE 方面的预测能力。

材料和方法

本回顾性研究纳入了 174 例接受 CIED 治疗的患者。根据是否存在 AHRE 将研究人群分为两组:AHRE(+)患者和 AHRE(-)患者。然后,分析患者的基线特征和评分系统,以预测 AHRE。

结果

评估了根据 AHRE 存在情况对患者基线特征和评分系统的分布。此外,还研究了卒中风险评分系统的 ROC 曲线分析,以预测 AHRE 的发生。ATRIA 预测 AHRE 的特异性为 92%,敏感性为 37.5%,当 ATRIA 值>6 时,其预测效果优于其他评分系统(AUC:0.700,0.626-0.767,95%置信区间(CI),p=0.004)。

结论

AHRE 在接受 CIED 治疗的患者中很常见。在这种情况下,已经使用了几种风险评分系统来预测接受 CIED 治疗的患者中 AHRE 的发展。本研究的结果表明,ATRIA 卒中风险评分系统在预测 AHRE 方面优于其他常用的风险评分系统。

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