[A comparison of CAS risk model and CHA2DS2-VASc risk model in guiding anticoagulation treatment in Chinese patients with non-valvular atrial fibrillation].

作者
Jie Deng,Lina He,Chao Jiang,Yongqiang Lai,De Yong Long,C H Sang,Chongqi Jia,Liang Feng,Xiaotian Li,Man Ning,Roumu Hu,J Z Dong,Xuechao Du,R B Tang,C S
出处
期刊:PubMed 卷期号:50 (9): 888-894
标识
DOI:10.3760/cma.j.cn112148-20210826-00740
摘要

Objective: To compare the differences between CAS risk model and CHA2DS2-VASc risk score in predicting all cause death, thromboembolic events, major bleeding events and composite endpoint in patients with nonvalvular atrial fibrillation. Methods: This is a retrospective cohort study. From the China Atrial Fibrillation Registry cohort study, the patients with atrial fibrillation who were>18 years old were randomly divided into CAS risk score group and CHA2DS2-VASc risk score group respectively. According to the anticoagulant status at baseline and follow-up, patients in the 2 groups who complied with the scoring specifications for anticoagulation were selected for inclusion in this study. Baseline information such as age and gender in the two groups were collected and compared. Follow-up was performed periodically to collect information on anticoagulant therapy and endpoints. The endpoints were all-cause death, thromboembolism events and major bleeding, the composite endpoint events were all-cause death and thromboembolism events. The incidence of endpoints in CAS group and CHA2DS2-VASc group was analyzed, and multivariate Cox proportional risk model was used to analyze whether the incidence of the endpoints was statistically different between the two groups. Results: A total of 5 206 patients with AF were enrolled, average aged (63.6±12.2) years, and 2092 (40.2%) women. There were 2 447 cases (47.0%) in CAS risk score group and 2 759 cases (53.0%) in CHA2DS2-VASc risk score group. In the clinical baseline data of the two groups, the proportion of left ventricular ejection fraction<55%, non-paroxysmal atrial fibrillation, oral warfarin and HAS BLED score in the CAS group were lower than those in the CHA2DS2-VASc group, while the proportion of previous diabetes history and history of antiplatelet drugs in the CAS group was higher than that in the CHA2DS2-VASc group, and there was no statistical difference in other baseline data. Patients were followed up for (82.8±40.8) months. In CAS risk score group, 225(9.2%) had all-cause death, 186 (7.6%) had thromboembolic events, 81(3.3%) had major bleeding, and 368 (15.0%) had composite endpoint. In CHA2DS2-VASc risk score group, 261(9.5%) had all-cause death 209(7.6%) had thromboembolic events, 112(4.1%) had major bleeding, and 424 (15.4%) had composite endpoint. There were no significant differences in the occurrence of all-cause death, thromboembolic events, major bleeding and composite endpoint between anticoagulation in CAS risk score group and anticoagulation in CHA2DS2-VASc risk score group (log-rank P =0.643, 0.904, 0.126, 0.599, respectively). Compared with CAS risk score, multivariable Cox proportional hazards regression models showed no significant differences for all-cause death, thromboembolic events, major bleeding and composite endpoint between the two groups with HR(95%CI) 0.95(0.80-1.14), 1.00(0.82-1.22), 0.83(0.62-1.10), 0.96(0.84-1.11), respectively. All P>0.05. Conclusions: There were no significant differences between CAS risk model and CHA2DS2-VASc risk score in predicting all-cause death, thromboembolic events, and major bleeding events in Chinese patients with non-valvular atrial fibrillation.目的: 比较CAS和CHA2DS2-VASc评分两种卒中风险评估模型预测非瓣膜性心房颤动(房颤)患者全因死亡、血栓栓塞、大出血事件以及复合终点发生方面的差异。 方法: 本研究为回顾性队列研究。从中国房颤注册研究(CAFR)中,选取年龄>18岁的非瓣膜性房颤患者,随机分为CAS评分组和CHA2DS2-VASc评分组,并根据基线和随访过程中抗凝状态筛选出2组中依从评分规范抗凝的患者纳入本研究。收集并比较两组患者的年龄、性别等基本信息,并定期进行随访,随访内容包括是否接受抗凝治疗以及终点事件。终点事件为全因死亡、血栓栓塞和大出血事件,复合终点事件为全因死亡和血栓栓塞事件。分析CAS评分组和CHA2DS2-VASc评分组相关终点事件发生情况,并采用多因素Cox比例风险模型比较两组相关终点事件发生率的差异。 结果: 共纳入5 206例房颤患者,年龄(63.6±12.2)岁,女性2 092例(40.2%)。其中CAS评分组2 447例(47.0%),CHA2DS2-VASc评分组2 759例(53.0%)。CAS组左心室射血分数<55%、非阵发性房颤、口服华法林比例以及HAS-BLED评分低于CHA2DS2-VASC组,而既往糖尿病病史和抗血小板药物服药史比例高于CHA2DS2-VASC组,其余基线资料差异无统计学意义。随访(82.8±40.8)个月,CAS评分组中有225例(9.2%)发生全因死亡,186例(7.6%)发生血栓栓塞事件,81例(3.3%)发生大出血事件,368例(15.0%)发生复合终点事件。CHA2DS2-VASc评分组有261例(9.5%)发生全因死亡,209例(7.6%)发生血栓栓塞事件,112例(4.1%)发生大出血事件,424例(15.4%)发生复合终点事件。两组患者在全因死亡、血栓栓塞、大出血事件以及复合终点事件发生方面差异均无统计学意义(log-rank P值分别为0.643、0.904、0.126、0.599)。Cox多因素回归分析结果也显示,两组患者在全因死亡、血栓栓塞、大出血事件以及复合终点发生方面差异均无统计学意义,HR值(95%CI)分别为0.95(0.80~1.14)、1.00(0.82~1.22)、0.83(0.62~1.10)、0.96(0.84~1.11),P均>0.05。 结论: 在中国非瓣膜性房颤患者中,CAS评分和CHA2DS2-VASc评分在预测全因死亡、血栓栓塞事件以及大出血事件方面效价相同。.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
大方的梦露完成签到,获得积分10
刚刚
烟花应助派大珊采纳,获得10
刚刚
万能图书馆应助陈辰采纳,获得10
刚刚
lee关注了科研通微信公众号
1秒前
都是发布了新的文献求助10
1秒前
ypeng完成签到,获得积分10
2秒前
HAHAHA完成签到,获得积分10
3秒前
务实的语风完成签到,获得积分10
3秒前
脑洞疼应助都是采纳,获得10
4秒前
丘比特应助ZS采纳,获得10
5秒前
Judy完成签到 ,获得积分10
5秒前
5秒前
药化行者完成签到,获得积分20
6秒前
7秒前
所所应助浮浮采纳,获得10
7秒前
罗_给翡冷翠的求助进行了留言
7秒前
Andrew关注了科研通微信公众号
8秒前
8秒前
发财小彤完成签到,获得积分10
9秒前
朴实的面包完成签到 ,获得积分10
9秒前
10秒前
小巧曲奇完成签到,获得积分10
10秒前
地狱跳跳虎完成签到 ,获得积分10
10秒前
英姑应助纯真的白开水采纳,获得10
11秒前
派大珊发布了新的文献求助10
12秒前
林钟望完成签到,获得积分10
12秒前
12秒前
李健应助千秋骚年采纳,获得30
13秒前
Jasper应助大民王采纳,获得10
14秒前
Raylihuang应助嘉丽的后花园采纳,获得200
14秒前
友好的小虾米完成签到,获得积分10
15秒前
只有个石头完成签到,获得积分10
16秒前
16秒前
16秒前
淡然白安发布了新的文献求助10
16秒前
17秒前
薰硝壤应助踏实的映易采纳,获得10
17秒前
yao发布了新的文献求助10
21秒前
naturehome发布了新的文献求助10
21秒前
吴帆发布了新的文献求助10
23秒前
高分求助中
The ACS Guide to Scholarly Communication 2500
Sustainability in Tides Chemistry 2000
Studien zur Ideengeschichte der Gesetzgebung 1000
TM 5-855-1(Fundamentals of protective design for conventional weapons) 1000
Threaded Harmony: A Sustainable Approach to Fashion 810
Pharmacogenomics: Applications to Patient Care, Third Edition 800
Genera Insectorum: Mantodea, Fam. Mantidæ, Subfam. Hymenopodinæ (Classic Reprint) 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3082743
求助须知:如何正确求助?哪些是违规求助? 2736027
关于积分的说明 7539806
捐赠科研通 2385554
什么是DOI,文献DOI怎么找? 1264970
科研通“疑难数据库(出版商)”最低求助积分说明 612857
版权声明 597685