TY - JOUR
T1 - Mortality prediction using CHADS2 /CHA2 DS2 -VASc/R2 CHADS2 scores in systolic heart failure patients with or without atrial fibrillation
AU - Chen, Yung Lung
AU - Cheng, Ching Lan
AU - Huang, Jin Long
AU - Yang, Ning I.
AU - Chang, Heng Chia
AU - Chang, Kuan Cheng
AU - Sung, Shih Hsien
AU - Shyu, Kou Gi
AU - Wang, Chun Chieh
AU - Yin, Wei Hsian
AU - Lin, Jiunn Lee
AU - Chen, Shyh Ming
N1 - Publisher Copyright:
Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - The CHADS2, CHA2 DS2 -VASc, and R2 CHADS 2 scores are well-known predictors of stroke caused by atrial fibrillation (AF), but no studies have evaluated their use for stratifying all-cause mortality risk in patients discharged for systolic heart failure (SHF) with or without AF. This study analyzed data in the Taiwan Society of Cardiology - heart failure with reduced ejection fraction (TSOC-HFrEF) registry. These data were obtained by a prospective, multicenter, observational survey of patients treated at 21 medical centers in Taiwan after hospitalization for acute, pre-existing or new onset SHF from May, 2013 to October, 2014. During 1 year follow-up, 198 patients were lost follow-up, and final 1311 (86.8%) patients were included for further analysis. During the follow-up period, 250 (19%) patients died. Multivariate analysis revealed that body mass index, thyroid disorder, valvular surgery history, chronic kidney disease (CKD), and scores for CHADS2, CHA2 DS2- VASc, and R2 CHADS2 were significant independent predictors of mortality in the overall population of SHF patients (all P<.05) The c-indexes showed that CHADS2, CHA2 DS2 -VASc, and R2 CHADS2 scores were significantly associated with mortality in SHF patients with or without AF (all P<005). However, R2 CHADS2 had significantly higher accuracy in predicting mortality in all SHF patients compared with CHADS2 and CHA2 DS2 -VASc (DeLong test, P<.0001), especially in SHF without AF (DeLong test, P=.0003). Scores for CHADS2, CHA2 DS2 -VASc, and R2 CHADS2 can be used to predict 1-year all-cause mortality in SHF patients with or without AF. For predicting all-cause mortality in SHF patients, R 2 CHADS 2 is more accurate than CHADS2 and CHA2 DS2 -VASc.
AB - The CHADS2, CHA2 DS2 -VASc, and R2 CHADS 2 scores are well-known predictors of stroke caused by atrial fibrillation (AF), but no studies have evaluated their use for stratifying all-cause mortality risk in patients discharged for systolic heart failure (SHF) with or without AF. This study analyzed data in the Taiwan Society of Cardiology - heart failure with reduced ejection fraction (TSOC-HFrEF) registry. These data were obtained by a prospective, multicenter, observational survey of patients treated at 21 medical centers in Taiwan after hospitalization for acute, pre-existing or new onset SHF from May, 2013 to October, 2014. During 1 year follow-up, 198 patients were lost follow-up, and final 1311 (86.8%) patients were included for further analysis. During the follow-up period, 250 (19%) patients died. Multivariate analysis revealed that body mass index, thyroid disorder, valvular surgery history, chronic kidney disease (CKD), and scores for CHADS2, CHA2 DS2- VASc, and R2 CHADS2 were significant independent predictors of mortality in the overall population of SHF patients (all P<.05) The c-indexes showed that CHADS2, CHA2 DS2 -VASc, and R2 CHADS2 scores were significantly associated with mortality in SHF patients with or without AF (all P<005). However, R2 CHADS2 had significantly higher accuracy in predicting mortality in all SHF patients compared with CHADS2 and CHA2 DS2 -VASc (DeLong test, P<.0001), especially in SHF without AF (DeLong test, P=.0003). Scores for CHADS2, CHA2 DS2 -VASc, and R2 CHADS2 can be used to predict 1-year all-cause mortality in SHF patients with or without AF. For predicting all-cause mortality in SHF patients, R 2 CHADS 2 is more accurate than CHADS2 and CHA2 DS2 -VASc.
KW - atrial fibrillation
KW - mortality
KW - risk score
KW - systolic heart failure
UR - http://www.scopus.com/inward/record.url?scp=85032615429&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000008338
DO - 10.1097/MD.0000000000008338
M3 - Article
C2 - 29069008
AN - SCOPUS:85032615429
SN - 0025-7974
VL - 96
JO - Medicine (United States)
JF - Medicine (United States)
IS - 43
M1 - e8338
ER -