Validity of HELT-ES Score in Predicting Ischemic Stroke in Japanese Patients With Non-Valvular Atrial Fibrillation With Cardiac Implantable Electronic Devices.

BACKGROUND

The HELT-ESscore, a novel risk stratification system, was developed to determine the incidence of ischemic stroke in Japanese patients with non-valvular atrial fibrillation (NVAF). It has been suggested that the HELT-ESscore is more useful than the CHADSand CHADS-VASc scores for Japanese patients with NVAF. This study determined the incidence of ischemic stroke in patients with NVAF and cardiac implantable electronic devices (CIEDs) and assessed the validity of the HELT-ESscore in this population.

METHODS AND RESULTS

We retrospectively analyzed the database of the CIED clinic of Chiba University Hospital and investigated the incidence of ischemic stroke according to the HELT-ESscore. Of the 730 consecutive patients who were followed-up at the CIED clinic, those without NVAF were excluded, leaving 362 patients in this study (mean [±SD] follow-up period, 64±48 months; mean age, 73±16 years; 65% male). The mean CHADSand CHADS-VASc scores were 1.8±1.2 and 2.8±1.6 points, respectively. During follow-up, 31 (8.6%) patients experienced ischemic stroke. The c-statistic for the HELT-ESscore was 0.719 (95% confidence interval [CI] 0.657-0.795), which was higher than the c-statistics for the CHADS(0.704; 95% CI 0.647-0.768; P=0.025) and CHADS-VASc (0.700; 95% CI:0.621-0.747; P=0.0097) scores.

CONCLUSIONS

Risk stratification for ischemic stroke using the HELT-ESscore is valid in Japanese patients with NVAF and CIEDs.