| Autor: |
Chen YL; Section of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City Chang Gung University College of Medicine Department of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University Cardiovascular Center, Taichung Veterans General Hospital, Taichung Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung Division of Cardiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City Graduate Institute of Biomedical Sciences, China Medical University Division of Cardiovascular Medicine, China Medical University Hospital, Taichung Division of Cardiology, Taipei Veterans General Hospital Division of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei Division of Cardiology, Chang Gung Memorial Hospital, Linkou Heart Center, Cheng Hsin General Hospital Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China., Cheng CL, Huang JL, Yang NI, Chang HC, Chang KC, Sung SH, Shyu KG, Wang CC, Yin WH, Lin JL, Chen SM |
| Abstrakt: |
The CHADS2, CHA2DS2-VASc, and R2CHADS2 scores are well-known predictors of stroke caused by atrial fibrillation (AF), but no studies have evaluated their use for stratifying all-cause mortality risk in patients discharged for systolic heart failure (SHF) with or without AF.This study analyzed data in the Taiwan Society of Cardiology-heart failure with reduced ejection fraction (TSOC-HFrEF) registry. These data were obtained by a prospective, multicenter, observational survey of patients treated at 21 medical centers in Taiwan after hospitalization for acute, pre-existing or new onset SHF from May, 2013 to October, 2014. During 1 year follow-up, 198 patients were lost follow-up, and final 1311 (86.8%) patients were included for further analysis. During the follow-up period, 250 (19%) patients died. Multivariate analysis revealed that body mass index, thyroid disorder, valvular surgery history, chronic kidney disease (CKD), and scores for CHADS2, CHA2DS2-VASc, and R2CHADS2 were significant independent predictors of mortality in the overall population of SHF patients (all P < .05) The c-indexes showed that CHADS2, CHA2DS2-VASc, and R2CHADS2 scores were significantly associated with mortality in SHF patients with or without AF (all P < 005). However, R2CHADS2 had significantly higher accuracy in predicting mortality in all SHF patients compared with CHADS2 and CHA2DS2-VASc (DeLong test, P < .0001), especially in SHF without AF (DeLong test, P = .0003).Scores for CHADS2, CHA2DS2-VASc, and R2CHADS2 can be used to predict 1-year all-cause mortality in SHF patients with or without AF. For predicting all-cause mortality in SHF patients, R2CHADS2 is more accurate than CHADS2 and CHA2DS2-VASc. |
