Predicting stroke and death in patients with heart failure using CHA2DS2-VASc score in Asia

被引:13
作者
Son, Mi Kyoung [1 ]
Lim, Nam-Kyoo [1 ]
Park, Hyun-Young [2 ]
机构
[1] Korea Natl Inst Hlth, Div Cardiovasc Dis, 187 OsongSaengmyeong2-Ro, Cheongju, Chungcheongbuk, South Korea
[2] Korea Natl Inst Hlth, Ctr Genome Sci, 187 OsongSaengmyeong2-Ro, Cheongju, Chungcheongbuk, South Korea
来源
BMC CARDIOVASCULAR DISORDERS | 2019年 / 19卷 / 01期
关键词
Heart failure; Stroke; Atrial fibrillation; CHA(2)DS(2)-VASc score; ATRIAL-FIBRILLATION; RISK STRATIFICATION; COMPETING RISK; THROMBOEMBOLISM;
D O I
10.1186/s12872-019-1178-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The CHA(2)DS(2)-VASc score is used to assess risk of mortality as well as to stratify risk of stroke in patients with atrial fibrillation (AF). This study evaluated whether CHA(2)DS(2)-VASc score was predictive of 1 and 2 year risks of stroke and death in Asian patients with heart failure (HF). Methods Patients hospitalized for HF were enrolled in the Korean Acute Heart Failure (KorAHF) registry, a prospective observational multicenter cohort study, between March 2011 and February 2014. Patients with a history of cancer before hospitalization for HF were excluded. The discriminatory properties of the CHA(2)DS(2)-VASc score were quantified using C-statistics. Results The study included 5158 patients with HF, 2091 with and 3067 without AF. Rates of stroke in these two groups were 4.5 and 2.8%, respectively, after 1 year, and 5.5 and 3.4%, respectively, after 2 years. Each 1-point increase in CHA(2)DS(2)-VASc score was associated with significantly increased risks of stroke and all-cause death in HF patients with and without AF (p-value < 0.05). The C-statistics of the CHA(2)DS(2)-VASc score for all-cause death in patients with and without AF were 0.600 and 0.630, respectively, at 1 year and 0.626 and 0.635, respectively, at 2 years. The C-statistics for stroke ranged from 0.593 to 0.639. Conclusions Among patients with incident HF with and without AF, CHA(2)DS(2)-VASc score was significantly associated with the risks of stroke and death. However, CHA(2)DS(2)-VASc score was only a modest predictor of stroke and death, indicating the need for studies evaluating modified CHA(2)DS(2)-VASc scores. The majority of strokes occurred relatively shortly after hospitalization for HF and that mortality rates in patients with HF remain high. Thus, early treatment after HF to prevent stroke is essential.
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页数:9
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共 25 条
  • [11] Epidemiology of Heart Failure in Korea: Present and Future
    Lee, Jung Hoon
    Lim, Nam-Kyoo
    Cho, Myeong-Chan
    Park, Hyun-Young
    [J]. KOREAN CIRCULATION JOURNAL, 2016, 46 (05) : 658 - 664
  • [12] Clinical Characteristics and Outcome of Acute Heart Failure in Korea: Results from the Korean Acute Heart Failure Registry (KorAHF)
    Lee, Sang Eun
    Lee, Hae-Young
    Cho, Hyun-Jai
    Choe, Won-Seok
    Kim, Hokon
    Choi, Jin Oh
    Jeon, Eun-Seok
    Kim, Min-Seok
    Kim, Jae-Joong
    Hwang, Kyung-Kuk
    Chae, Shung Chull
    Baek, Sang Hong
    Kang, Seok-Min
    Choi, Dong-Ju
    Yoo, Byung-Su
    Kim, Kye Hun
    Park, Hyun-Young
    Cho, Myeong-Chan
    Oh, Byung-Hee
    [J]. KOREAN CIRCULATION JOURNAL, 2017, 47 (03) : 341 - 353
  • [13] A multicentre cohort study of acute heart failure syndromes in Korea: rationale, design, and interim observations of the Korean Acute Heart Failure (KorAHF) registry
    Lee, Sang Eun
    Cho, Hyun-Jai
    Lee, Hae-Young
    Yang, Han-Mo
    Choi, Jin-Oh
    Jeon, Eun-Seok
    Kim, Min-Seok
    Kim, Jae-Joong
    Hwang, Kyung-Kuk
    Chae, Shung Chull
    Seo, Suk Min
    Baek, Sang Hong
    Kang, Seok-Min
    Oh, Il-Young
    Choi, Dong-Ju
    Yoo, Byung-Su
    Ahn, Youngkeun
    Park, Hyun-Young
    Cho, Myeong-Chan
    Oh, Byung-Hee
    [J]. EUROPEAN JOURNAL OF HEART FAILURE, 2014, 16 (06) : 700 - 708
  • [14] Comparative assessment of published atrial fibrillation stroke risk stratification schemes for predicting stroke, in a non-atrial fibrillation population: The Chin-Shan Community Cohort Study
    Lip, Gregory Y. H.
    Lin, Hung-Ju
    Chien, Kuo-Liong
    Hsu, Hsiu-Ching
    Su, Ta-Chen
    Chen, Ming-Fong
    Lee, Yuan-Teh
    [J]. INTERNATIONAL JOURNAL OF CARDIOLOGY, 2013, 168 (01) : 414 - 419
  • [15] Stroke and mortality in patients with incident heart failure: the Diet, Cancer and Health (DCH) cohort study
    Lip, Gregory Y. H.
    Rasmussen, Lars Hvilsted
    Skjoth, Flemming
    Overvad, Kim
    Larsen, Torben Bjerregaard
    [J]. BMJ OPEN, 2012, 2 (04):
  • [16] Refining Clinical Risk Stratification for Predicting Stroke and Thromboembolism in Atrial Fibrillation Using a Novel Risk Factor-Based Approach The Euro Heart Survey on Atrial Fibrillation
    Lip, Gregory Y. H.
    Nieuwlaat, Robby
    Pisters, Ron
    Lane, Deirdre A.
    Crijns, Harry J. G. M.
    [J]. CHEST, 2010, 137 (02) : 263 - 272
  • [17] EURObservational Research Programme: regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)
    Maggioni, Aldo P.
    Dahlstrom, Ulf
    Filippatos, Gerasimos
    Chioncel, Ovidiu
    Crespo Leiro, Marisa
    Drozdz, Jaroslaw
    Fruhwald, Friedrich
    Gullestad, Lars
    Logeart, Damien
    Fabbri, Gianna
    Urso, Renato
    Metra, Marco
    Parissis, John
    Persson, Hans
    Ponikowski, Piotr
    Rauchhaus, Mathias
    Voors, Adriaan A.
    Nielsen, Olav Wendelboe
    Zannad, Faiez
    Tavazzi, Luigi
    [J]. EUROPEAN JOURNAL OF HEART FAILURE, 2013, 15 (07) : 808 - 817
  • [18] Assessment of the CHA2DS2-VASc Score in Predicting Ischemic Stroke, Thromboembolism, and Death in Patients With Heart Failure With and Without Atrial Fibrillation
    Melgaard, Line
    Gorst-Rasmussen, Anders
    Lane, Deidre A.
    Rasmussen, Lars Hvilsted
    Larsen, Torben Bjerregaard
    Lip, Gregory Y. H.
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2015, 314 (10): : 1030 - 1038
  • [19] Prediction of stroke or TIA in patients without atrial fibrillation using CHADS2 and CHA2DS2-VASc scores
    Mitchell, L. Brent
    Southern, Danielle A.
    Galbraith, Diane
    Ghali, William A.
    Knudtson, Merril
    Wilton, Stephen B.
    [J]. HEART, 2014, 100 (19) : 1524 - 1530
  • [20] The risks of risk scores for stroke risk assessment in atrial fibrillation
    Nielsen, Peter Bronnum
    Chao, Tze-Fan
    [J]. THROMBOSIS AND HAEMOSTASIS, 2015, 113 (06) : 1170 - 1173