Atrial fibrillation and prediction of mortality by conventional clinical score systems according to the setting of care

Igor Diemberger, Elisa Fantecchi, Maria Letizia Bacchi Reggiani, Cristian Martignani, Andrea Angeletti, Giulia Massaro, Matteo Ziacchi, Mauro Biffi, Gregory Y.h. Lip, Giuseppe Boriani

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6 Citations (Scopus)
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Abstract

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.
Original languageEnglish
Pages (from-to)73-77
JournalInternational Journal of Cardiology
Volume261
Early online date14 Mar 2018
DOIs
Publication statusPublished - 15 Jun 2018

Keywords

  • outcomes
  • real world
  • registry
  • survival
  • arrhythmia

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