Prediction of postoperative atrial fibrillation after coronary artery bypass grafting surgery: Is CHA2DS2-VASc score useful?
Prediction of postoperative atrial fibrillation after coronary artery bypass grafting surgery: Is CHA2DS2-VASc score useful?
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DOI：
10.4103/0971-9784.135841
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发表时间：
2014-07-01
影响因子：
0.9
通讯作者：
Joshi, Shreedhar
中科院分区：
文献类型：
--
作者：
Borde, Deepak;Gandhe, Uday;Joshi, Shreedhar
目的和目的：术后房颤是冠状动脉旁路移植术后最常见的心律失常。对POAF高危患者的识别有助于指导预防治疗。目前，还没有简单的术前评分系统可用于预测POAF风险较高的患者。在一项回顾性观察研究中，我们评估了CHA(2)DS(2)-VASC评分预测CABG术后POAF的有效性。材料和方法：在获得机构审查委员会批准后，纳入729例在体外循环(CPB)下进行冠脉搭桥术的患者。在POAF术后对患者进行随访。用多元回归分析从不同的变量预测POAF。计算受试者工作特征(ROC)曲线下面积以检验CHA(2)DS(2)-VASC评分预测POAF的区分力。结果：95例(13%)患者发生POAF。有POAF的患者CHA(2)DS(2)-VASC评分高于无POAF的患者(4.09±-0.90vs.2.31±1.21；P<；0.001)。心脏手术后POAF发生率随CHA(2)DS(2)-VASc评分增加而增加。CHA2DS2-VASc评分越高，预测POAF的优势比越高(3.68)。当CHA(2)DS(2)-VASC评分计算ROC曲线时，面积为0.87，具有统计学意义(P<；0.0001)。结论：CHA(2)DS(2)-VASC评分对预测CABG术后POAF有一定价值。该评分系统简单易行，可在术前提醒临床医生冠状动脉旁路移植术后发生POAF的可能性较高。
Aims and Objectives: Postoperative atrial fibrillation (POAF) is the most common arrhythmia after coronary artery bypass grafting (CABG) surgery. The identification of patients at risk for POAF would be helpful to guide prophylactic therapy. Presently, there is no simple preoperative scoring system available to predict patients at higher risk of POAF. In a retrospective observational study, we evaluated the usefulness of CHA(2)DS(2)-VASc score to predict POAF after CABG. Materials and Methods: After obtaining approval from Institutional Review Board, 729 patients undergoing CABG on cardiopulmonary bypass (CPB) were enrolled. Patients were followed in the postoperative period for POAF. A multiple regression analysis was run to predict POAF from various variables. The area under the receiver operating characteristic (ROC) curve was calculated to test discriminatory power of CHA(2)DS(2)-VASc score to predict POAF. Results: POAF occurred in 95 (13%) patients. The patients with POAF had higher CHA(2)DS(2)-VASc scores than those without POAF (4.09 +/- 0.90 vs. 2.31 +/- 1.21; P < 0.001). The POAF rates after cardiac surgery increased with increasing CHA(2)DS(2)-VASc scores. The odds ratio for predicting POAF was highest with higher CHA2DS2-VASc scores (3.68). When ROC curve was calculated for the CHA(2)DS(2)-VASc scores, area of 0.87 was obtained, which was statistically significant (P < 0.0001). Conclusions: The CHA(2)DS(2)-VASc score was found useful in predicting POAF after CABG. This scoring system is simple and convenient to use in the preoperative period to alert the clinician about higher probability of POAF after CABG surgery.