Preoperative CHA 2 DS 2 -VASc Score is Associated With Postoperative Survival Following Surgical Ablation Concomitantly With Other Cardiac Surgery.

Autor: Lauritzen DJ; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. Electronic address: djl@clin.au.dk., Vodstrup HJ; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Christensen TD; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Hald MO; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Christensen R; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark., Heiberg J; Department of Anaesthesia, Copenhagen University Hospital, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Heart, lung & circulation [Heart Lung Circ] 2021 Dec; Vol. 30 (12), pp. 1942-1948. Date of Electronic Publication: 2021 Jun 01.
DOI: 10.1016/j.hlc.2021.05.076
Abstrakt: Background: The CHA 2 DS 2 -VASc scoring system has been shown to predict long-term outcomes in patients undergoing catheter ablation but has not yet been investigated for patients undergoing surgical ablation. Therefore, the objective was to evaluate the ability of CHA 2 DS 2 -VASc to predict long-term outcomes after surgical ablation.
Method: In a retrospective study, patients were included if they underwent surgical ablation concomitantly with other cardiac surgery. Patients were divided into low-risk (score 0-1), medium-risk (score 2-4) and high-risk (score ≥5) groups based on their CHA 2 DS 2 -VASc score. Data on survival, atrial fibrillation (AF) recurrence, and stroke were collected retrospectively at the end of the follow-up period.
Results: A total of 587 patients underwent surgical ablation concomitantly with other cardiac surgery. Survival analysis revealed a difference between the three stratified CHA 2 DS 2 -VASc risk groups, (p<0.001). Similarly, there was a difference in AF recurrence rates between stratified CHA 2 DS 2 -VASc groups among patients with persistent/long-standing persistent AF (p=0.018). There were no statistically significant differences between stratified CHA 2 DS 2 -VASc risk groups in terms of recurrence rates of paroxysmal AF or stroke. Finally, the CHA 2 DS 2 -VASc scoring system was an independent predictor of 5-year mortality after adjusting for potential confounders (hazard ratio 1.25; p=0.002).
Conclusions: Preoperative CHA 2 DS 2 -VASc scores were associated with postoperative survival in patients undergoing surgical ablation for AF. Post-hoc analyses showed that CHA 2 DS 2 -VASc was also a predictor of AF recurrence in patients with persistent/long-standing persistent AF. However, this needs to be confirmed in a prospective study.
(Copyright © 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: