CHADS(2) and CHA(2)DS(2)-VASc scores in the prediction of clinical outcomes in patients with atrial fibrillation after catheter ablation

Tze-Fan Chao, Yenn-Jiang Lin, Hsuan-Ming Tsao, Chin-Feng Tsai, Wei-Shiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Kazuyoshi Suenari, Cheng-Hung Li, Beny Hartono, Hung-Yu Chang, Kibos Ambrose, Tsu-Juey Wu, Shih-Ann Chen
Journal of the American College of Cardiology 2011 November 29, 58 (23): 2380-5

OBJECTIVES: This study aimed to evaluate whether CHADS(2) and CHA(2)DS(2)-VASc scores are useful for risk stratification in patients after catheter ablation of atrial fibrillation (AF).

BACKGROUND: AF is associated with increased risk of cardiovascular events. However, limited data are available on the predictors of adverse events in patients with AF after catheter ablation.

METHODS: A total of 565 patients with AF who underwent catheter ablation were enrolled in the study. The clinical endpoint was occurrence of thromboembolic events (ischemic stroke, transient ischemic attack, peripheral embolism, or pulmonary embolisms) or death during follow-up after catheter ablation.

RESULTS: During a follow-up of 39.2 ± 22.6 months, 27 patients (4.8%) experienced adverse events. Both the CHADS(2) and CHA(2)DS(2)-VASc scores were useful predictors of events in separate multivariate models. The areas under the receiver-operator characteristic curves based on the CHADS(2) and CHA(2)DS(2)-VASc scores in predicting events were 0.785 and 0.830, respectively. Although the difference did not reach statistical significance (p = 0.116), the CHA(2)DS(2)-VASc score could be used to further stratify the patients with CHADS(2) scores of 0 or 1 into 2 groups with different event rates (7.1% vs. 1.1%, p = 0.003) at a cutoff value of 2.

CONCLUSIONS: The CHADS(2) and CHA(2)DS(2)-VASc scores are useful predictors of adverse events after catheter ablation of AF.

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