The CHA2DS2-VASc score for predicting atrial fibrillation in patients presenting with ST elevation myocardial infarction: prospective observational study
São Paulo med. j
; São Paulo med. j;137(3): 248-254, May-June 2019. tab, graf
Article
de En
| LILACS
| ID: biblio-1020955
Bibliothèque responsable:
BR1.1
ABSTRACT
ABSTRACT BACKGROUND:
Atrial fibrillation (AF) is the most common form of supraventricular arrhythmia following ST-elevation myocardial infarction (STEMI). The CHA2DS2-VASc and CHADS2 scores are used to estimate thromboembolic risk in cases of AF. Their usefulness in predicting the development of AF in patients presenting STEMI is unknown.OBJECTIVE:
To evaluate the predictive value of the CHADS2 and CHA2DS2-VASc scores in patients with AF following STEMI. DESIGN ANDSETTING:
This prospective cohort study on 696 patients with STEMI was conducted at a tertiary-level cardiology clinic in a public university hospital.METHODS:
Models including clinical and laboratory parameters were constructed to test the predictive value of CHADS2 and CHA2DS2-VASc scores. Patients were divided into two groups with and without AF. Predictors of AF were determined using multivariate regression analysis.RESULTS:
In the patients with AF, CHADS2 and CHA2DS2-VASc scores were significantly higher than in those without AF (for both P < 0.001). Factors associated with AF in multivariate analyses included CHA2DS2-VASc score (odds ratio, OR 1.48; 95% confidence interval, CI 1.25-1.75; P < 0.001), peak creatine kinase-myocardial binding (OR 1.002; 95% CI 1.00-1.003; P = 0.0024), duration of the coronary intensive care unit stay (OR 1.69; 95% CI 1.24-12.30; P = 0.001) and no use of renin-angiotensin system blockers (OR 2.16; 95% CI 1.14-4.10; P = 0.0017). Receiver operating characteristic curve analyses showed that CHA2DS2-VASc scores were significant predictors for new-onset AF (C-statistic 0.698; 95% CI 0.631-0.765; P < 0.001).CONCLUSION:
CHADS2 and CHA2DS2-VASc scores predicted new AF in patients presenting STEMI.Mots clés
Texte intégral:
1
Indice:
LILACS
Sujet Principal:
Fibrillation auriculaire
/
Infarctus du myocarde avec sus-décalage du segment ST
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites du sujet:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
langue:
En
Texte intégral:
Sao Paulo Med J
/
São Paulo med. j
/
São Paulo med. j. (Online)
/
São Paulo medical journal (Impresso)
Thème du journal:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
MEDICINA
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Année:
2019
Type:
Article