Use of Preoperative CHA(2)DS(2)-VASc Score to Predict the Risk of Atrial Fibrillation After Cardiothoracic Surgery: A Nested Case-Control Study from the Atrial Fibrillation Suppression Trials (AFIST) I, II, and III

作者：Baker William L^*; Coleman Craig I; White C Michael; Kluger Jeffrey

来源：Pharmacotherapy, 2013, 33(5): 489-495.

DOI：10.1002/phar.1235

• CHA(2)DS(2)-VASc
• atrial fibrillation
• cardiac surgery

Study Objective. To evaluate whether the preoperative CHA(2)DS(2)-VASc score predicts the risk of atrial fibrillation (AF) after cardiothoracic surgery (CTS). %26lt;br%26gt;Design. Retrospective, nested case-control study. Patients. A total of 560 patients undergoing coronary artery bypass grafting and/or valvular surgery from the Atrial Fibrillation Suppression Trials I, II, and III. %26lt;br%26gt;Measurements and Main Results. All variables showing a univariate association (p %26lt;= 0.20) with AF occurrence were entered into a backward stepwise multivariate logistic regression analysis to control for potential confounders and to calculate adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The population was age 67.8 +/- 8.6 (mean +/- SD) years and 77.1% male, with CHA(2)DS(2)-VASc scores of 0-1 (low) in 34 patients (6.1%), 2-3 (medium) in 261 patients (46.6%), and more than 3 (high) in 265 patients (47.3%). Post-CTS AF occurred in 177 patients (31.6%), with 27%, 23%, and 41% in the low-, medium-, and high-CHA(2)DS(2)-VASc score groups, respectively. The high-score group had a 2.3-fold increased odds of developing AF versus the medium-score group (p%26lt;0.0001). The differences between the high-and medium-score groups when each group was compared with the low-score group were not statistically significant. On the multivariate logistic regression analysis, CHA(2)DS(2)-VASc score was associated with development of AF (AOR 1.20, 95% CI 1.06-1.36). %26lt;br%26gt;Conclusion. Increasing CHA(2)DS(2)-VASc score was an independent predictor for the development of post-CTS AF, with patients in the high-score group having the highest overall incidence.

• 出版日期2013-5