TY - JOUR
T1 - Atrial fibrillation and prediction of mortality by conventional clinical score systems according to the setting of care
AU - Diemberger, Igor
AU - Fantecchi, Elisa
AU - Reggiani, Maria Letizia Bacchi
AU - Martignani, Cristian
AU - Angeletti, Andrea
AU - Massaro, Giulia
AU - Ziacchi, Matteo
AU - Biffi, Mauro
AU - Lip, Gregory Y H
AU - Boriani, Giuseppe
N1 - Copyright © 2017. Published by Elsevier B.V.
PY - 2018
Y1 - 2018
N2 - BACKGROUND: Atrial fibrillation (AF) is associated with high morbidity and mortality, also among anticoagulated patients. Our aim was to evaluate the predictive role for long-term mortality of a series of risk stratification scores associated with cardiovascular or thromboembolic outcomes (CHADS2, CHA2DS2-VASc, ATRIA, TIMI-AF), and bleeding complications (HAS-BLED) in an unselected population of patients with AF.METHODS: Single center, observational, prospective registry of consecutive patients with AF, undergoing clinical/echocardiographic evaluation in a University Hospital, as either in-patients or out-patients. We assessed the role of each single score as predictors of long-term survival according to clinical setting.RESULTS: We enrolled 1051 patients, mean age 72 ± 12 years, who were followed for 797 ± 298 days. All the tested scores showed a good performance in prediction of mortality, together with several clinical factors (older age, chronic heart failure, diabetes, renal impairment, previous transient ischemic attack, left ventricular ejection fraction). The values at C-statistics ranged between modest (0.608-0.684) of inpatients to good (0.708-0.751) in outpatients without any statistical difference between the scores, excepted a lower performance of HAD-BLED.CONCLUSIONS: Risk scores currently adopted for decision making on starting oral anticoagulation provide good prediction of long-term survival in unselected AF patients, especially in the outpatient setting.
AB - BACKGROUND: Atrial fibrillation (AF) is associated with high morbidity and mortality, also among anticoagulated patients. Our aim was to evaluate the predictive role for long-term mortality of a series of risk stratification scores associated with cardiovascular or thromboembolic outcomes (CHADS2, CHA2DS2-VASc, ATRIA, TIMI-AF), and bleeding complications (HAS-BLED) in an unselected population of patients with AF.METHODS: Single center, observational, prospective registry of consecutive patients with AF, undergoing clinical/echocardiographic evaluation in a University Hospital, as either in-patients or out-patients. We assessed the role of each single score as predictors of long-term survival according to clinical setting.RESULTS: We enrolled 1051 patients, mean age 72 ± 12 years, who were followed for 797 ± 298 days. All the tested scores showed a good performance in prediction of mortality, together with several clinical factors (older age, chronic heart failure, diabetes, renal impairment, previous transient ischemic attack, left ventricular ejection fraction). The values at C-statistics ranged between modest (0.608-0.684) of inpatients to good (0.708-0.751) in outpatients without any statistical difference between the scores, excepted a lower performance of HAD-BLED.CONCLUSIONS: Risk scores currently adopted for decision making on starting oral anticoagulation provide good prediction of long-term survival in unselected AF patients, especially in the outpatient setting.
KW - Arrhythmia
KW - Outcomes
KW - Real world
KW - Registry
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85044157064&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2018.03.058
DO - 10.1016/j.ijcard.2018.03.058
M3 - Journal article
C2 - 29572083
SN - 0167-5273
VL - 261
SP - 73
EP - 77
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -