CHADS2 and CHA2DS2-VASc scoring systems for predicting atrial fibrillation following cardiac valve surgery.
CHADS2 and CHA2DS2-VASc scoring systems for predicting atrial fibrillation following cardiac valve surgery.
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用于预测心脏瓣膜手术后心房颤动的 CHADS2 和 CHA2DS2-VASc 评分系统
DOI：
10.1371/journal.pone.0123858
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Wang Z
中科院分区：
文献类型：
--
作者：
Yin L;Ling X;Zhang Y;Shen H;Min J;Xi W;Wang J;Wang Z
目的临床应用CHADS2和CHA2DS2-VASc评分系统预测心脏手术后房颤的临床应用已有报道，并证明了良好的预测价值。我们试图调查这两种评分系统是否能有效预测心脏瓣膜手术后房颤的新发，并证明其在临床评估中的潜在作用。方法回顾分析2003年1月至2013年12月在我校心脏中心接受心脏瓣膜手术的所有患者，术前无房颤。我们研究的主要结果终点是心脏瓣膜手术后早期新发的房颤。结果518例患者中，234例(45.17%)在瓣膜手术后发生POAF。有POAF的患者年龄较大(P=0.23)，体重指数较高(P=0.013)。心力衰竭(P=0.025)、高血压(P=0.021)、既往卒中或短暂性脑缺血发作(P=0.032)、冠心病(P=0.001)、颈动脉疾病(P=0.024)、术前应用他汀类药物(P=0.021)等病史在POAF组明显增多。房颤患者的左前降支(LAD)(P=0.013)和E/E‘比值(P<；0.001)也较高。CHADS_2和CHA_2DS_2-VASC评分在POAF组显著高于对照组(P=0.002；P&t；0.001)，单因素和多因素回归分析显示，CHADS_2和CHA_2DS_2-VASC评分是POAF的显著预测因素(P=0.001；P&t；0.001)。基于CHADS2和CHA2DS2-VASC评分的分层，Kaplan-Meier分析得到CHADS2和CHA2DS2-VASC评分分层越高的患者POAF发生率越高(P<；0.001；P<；0.001)。结论CHADS2和CHA2DS2-VASc评分与瓣膜手术后POAF的发生率直接相关，评分越高对POAF的预测作用越强。
Objective Clinical use of CHADS2 and CHA2DS2-VASc scoring systems for predicting AF following cardiac surgery have been reported in previous studies and demonstrated well-validated predictive value. We sought to investigate whether the two scoring systems are effective for predicting new-onset of AF following cardiac valve surgery and to demonstrate its potential utility of clinical assessment. Methods Medical records of all patients underwent cardiac valve surgeries during the period of January 2003 and December 2013 without preoperative AF at the cardiac center of our university were reviewed. The main outcome end point of our study was the early new-onset of AF following cardiac valve surgery. Results There were overall 518 patients involved in this study, with 234 (45.17%) developed POAF following valve surgery. Patients with POAF had older age (P=0.23) and higher BMI (P=0.013) than those without POAF. History of heart failure (P=0.025), hypertension (P=0.021), previous stroke or TIA (P=0.032), coronary artery disease (P=0.001), carotid artery disease (P=0.024) and preoperative medication of statins (P=0.021) were significantly more recorded in POAF group. Patients with POAF also had higher LAD (P=0.013) and E/e’ ratio (P<0.001). The CHADS2 and CHA2DS2-VASc scores were significantly higher in patients with POAF (P=0.002; P<0.001), and under univariate and multivariate regression analysis the CHADS2 and CHA2DS2-VASc scores were significant predictors of POAF (P=0.001; P<0.001). Based on stratification of CHADS2 and CHA2DS2-VASc scores, the Kaplan-Meier analysis obtained a higher POAF rate on patients with higher stratification of CHADS2 and CHA2DS2-VASc scores (P<0.001; P<0.001). Conclusion In conclusion, CHADS2 and CHA2DS2-VASc scores were directly associated with the incidence of POAF following valve surgery and a higher score was strongly predictive of POAF.
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影响因子：
4.8
作者：
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DOI：
10.1016/j.echo.2012.09.004
发表时间：
2012-12-01
影响因子：
6.5
作者：
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