CHA2DS2-VASc and SAMe-TT2R2 scores as predictors of recurrence for nonvalvular atrial fibrillation patients on vitamin K antagonists after radiofrequency catheter ablation

医学 心房颤动 内科学 置信区间 心脏病学 肺静脉 导管消融 单变量分析 射频消融术 烧蚀 多元分析
作者
Jianqiang Zhao,Dongchen Zhou,Miao Chen,Chengui Zhuo,Zhongyuan Lin,Liangrong Zheng,Qiqi Wang
出处
期刊:Journal of Cardiovascular Medicine [Lippincott Williams & Wilkins]
卷期号:21 (3): 200-208 被引量:4
标识
DOI:10.2459/jcm.0000000000000930
摘要

Aims Atrial fibrillation is the most common sustained arrhythmia in the general population, and circumferential pulmonary vein isolation has emerged as a cornerstone in the treatment of drug-resistant atrial fibrillation. However, there is a paucity of data regarding the CHA 2 DS 2 -VASc and SAMe-TT 2 R 2 scores as predictors of outcomes among patients with nonvalvular atrial fibrillation on vitamin K antagonists after radiofrequency catheter ablation (RFCA). Methods The current prospective observational study enrolled 304 consecutive patients with atrial fibrillation who underwent RFCA. Warfarin was maintained for at least 3 months after RFCA. The 1-year atrial fibrillation recurrence rate was documented. Results Persistent atrial fibrillation ( P = 0.003), heart failure ( P < 0.001), an enlarged left atrium ( P = 0.003), current smoking ( P < 0.001), the CHA 2 DS 2 -VASc score ( P = 0.001), and the SAMe-TT 2 R 2 score ( P < 0.001) were univariate associated with recurrent atrial fibrillation. Cutoff analysis showed that a CHA 2 DS 2 -VASc score at least 3 (areas under the curve = 0.612; 95% confidence interval 0.537–0.687) and a SAMe-TT 2 R 2 score at least 5 (areas under the curve = 0.642, 95% confidence interval 0.575–0.708) had the highest predictive value for atrial fibrillation recurrence. Patients with a CHA 2 DS 2 -VASc score at least 3 ( P < 0.001) and a SAMe-TT 2 R 2 score at least 5 ( P = 0.001) had a higher probability of experiencing atrial fibrillation recurrence after RFCA compared with patients with a CHA 2 DS 2 -VASc score less than 3 and a SAMe-TT 2 R 2 score less than 5. Conclusion CHA 2 DS 2 -VASc and SAMe-TT 2 R 2 scores were associated with 1-year recurrence of atrial fibrillation in patients on vitamin K antagonists after RFCA. For CHA 2 DS 2 -VASc and SAMe-TT 2 R 2 scores, a cutoff value of at least 3 and at least 5 had the highest predictive value for atrial fibrillation recurrence, respectively.
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