已入深夜,您辛苦了!由于当前在线用户较少,发布求助请尽量完整的填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!祝你早点完成任务,早点休息,好梦!

[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
春江发布了新的文献求助20
4秒前
隐形曼青应助626采纳,获得10
4秒前
4秒前
可耐的思远完成签到 ,获得积分10
6秒前
所所应助IKARUTO采纳,获得20
8秒前
伴你笑发布了新的文献求助10
8秒前
10秒前
阿飞发布了新的文献求助10
10秒前
Crane完成签到,获得积分10
10秒前
轮胎配方发布了新的文献求助10
15秒前
JamesPei应助steveshu采纳,获得10
15秒前
橘子发布了新的文献求助10
16秒前
17秒前
Gloria发布了新的文献求助10
17秒前
20秒前
黄钰发布了新的文献求助10
20秒前
英姑应助科研通管家采纳,获得10
23秒前
23秒前
大个应助科研通管家采纳,获得10
23秒前
科研通AI2S应助科研通管家采纳,获得10
23秒前
23秒前
伴你笑完成签到,获得积分10
23秒前
脑洞疼应助科研通管家采纳,获得10
23秒前
退学炒股发布了新的文献求助10
23秒前
英俊的铭应助科研通管家采纳,获得10
23秒前
科研通AI2S应助科研通管家采纳,获得10
23秒前
24秒前
香蕉觅云应助科研通管家采纳,获得10
24秒前
天天快乐应助科研通管家采纳,获得10
24秒前
25秒前
研友_VZG7GZ应助阿飞采纳,获得10
27秒前
29秒前
大个应助伴你笑采纳,获得10
29秒前
小昕思完成签到 ,获得积分10
29秒前
容止发布了新的文献求助10
35秒前
38秒前
38秒前
40秒前
15966014069发布了新的文献求助10
41秒前
汉堡包应助Captain采纳,获得10
43秒前
高分求助中
Evolution 10000
Sustainability in Tides Chemistry 2800
юрские динозавры восточного забайкалья 800
Diagnostic immunohistochemistry : theranostic and genomic applications 6th Edition 500
Chen Hansheng: China’s Last Romantic Revolutionary 500
China's Relations With Japan 1945-83: The Role of Liao Chengzhi 400
Classics in Total Synthesis IV 400
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 3150395
求助须知:如何正确求助?哪些是违规求助? 2801528
关于积分的说明 7845329
捐赠科研通 2459096
什么是DOI,文献DOI怎么找? 1308989
科研通“疑难数据库(出版商)”最低求助积分说明 628634
版权声明 601727