TY - JOUR
T1 - Mortality prediction using CHADS2 /CHA2 DS2 -VASc/R2 CHADS2 scores in systolic heart failure patients with or without atrial fibrillation
AU - Chen, Yung Lung
AU - Cheng, Ching Lan
AU - Huang, Jin Long
AU - Yang, Ning I.
AU - Chang, Heng Chia
AU - Chang, Kuan Cheng
AU - Sung, Shih Hsien
AU - Shyu, Kou Gi
AU - Wang, Chun Chieh
AU - Yin, Wei Hsian
AU - Lin, Jiunn Lee
AU - Chen, Shyh Ming
N1 - Funding Information:
Chang Gung Memorial Hospital, Keelung, Taiwan; Chang Gung Memorial Hospital, Linkou, Taiwan; Cheng Hsin General Hospital, Taipei, Taiwan; Chimei Medical Center, Tainan, Taiwan; China Medical University Hospital, Taichung, Taiwan; Chung-Shan Medical University Hospital, Taichung, Taiwan; E-Da Hospital, Kaohsiung, Taiwan; Far Eastern memorial Hospital, New Taipei City, Taiwan; Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan; Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; MacKay Memorial Hospital, Taipei, Taiwan; National Cheng Kung University Hospital, Tainan, Taiwan; National Taiwan University Hospital, Hsinchu Branch; National Taiwan University Hospital, Taipei, Taiwan; Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Taichung Veterans General Hospital, Taichung, Taiwan; Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; Taipei Veterans General Hospital, Taipei, Taiwan; Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
Funding Information:
The authors have no conflicts of interest to disclose. Supplemental Digital Content is available for this article. aSection of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, bChang Gung University College of Medicine, cDepartment of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, dCardiovascular Center, Taichung Veterans General Hospital, Taichung, eDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, fDivision of Cardiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, gGraduate Institute of Biomedical Sciences, China Medical University, hDivision of Cardiovascular Medicine, China Medical University Hospital, Taichung, iDivision of Cardiology, Taipei Veterans General Hospital, jDivision of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, kDivision of Cardiology, Chang Gung Memorial Hospital, Linkou, lHeart Center, Cheng Hsin General Hospital, mDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China. ∗Correspondence: Shyh-Ming Chen, Section of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Tai Pei Road, Niao Sung District, Kaohsiung City, Taiwan, Republic of China (e-mail: [email protected]).
Funding Information:
The TSOC-HFrEF Registry is supported by the Taiwan Society of Cardiology. The 21 medical centers that treated the patients enrolled in this study are listed below in alphabetical order.
Publisher Copyright:
Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - The CHADS2, CHA2 DS2 -VASc, and R2 CHADS 2 scores are well-known predictors of stroke caused by atrial fibrillation (AF), but no studies have evaluated their use for stratifying all-cause mortality risk in patients discharged for systolic heart failure (SHF) with or without AF. This study analyzed data in the Taiwan Society of Cardiology - heart failure with reduced ejection fraction (TSOC-HFrEF) registry. These data were obtained by a prospective, multicenter, observational survey of patients treated at 21 medical centers in Taiwan after hospitalization for acute, pre-existing or new onset SHF from May, 2013 to October, 2014. During 1 year follow-up, 198 patients were lost follow-up, and final 1311 (86.8%) patients were included for further analysis. During the follow-up period, 250 (19%) patients died. Multivariate analysis revealed that body mass index, thyroid disorder, valvular surgery history, chronic kidney disease (CKD), and scores for CHADS2, CHA2 DS2- VASc, and R2 CHADS2 were significant independent predictors of mortality in the overall population of SHF patients (all P<.05) The c-indexes showed that CHADS2, CHA2 DS2 -VASc, and R2 CHADS2 scores were significantly associated with mortality in SHF patients with or without AF (all P<005). However, R2 CHADS2 had significantly higher accuracy in predicting mortality in all SHF patients compared with CHADS2 and CHA2 DS2 -VASc (DeLong test, P<.0001), especially in SHF without AF (DeLong test, P=.0003). Scores for CHADS2, CHA2 DS2 -VASc, and R2 CHADS2 can be used to predict 1-year all-cause mortality in SHF patients with or without AF. For predicting all-cause mortality in SHF patients, R 2 CHADS 2 is more accurate than CHADS2 and CHA2 DS2 -VASc.
AB - The CHADS2, CHA2 DS2 -VASc, and R2 CHADS 2 scores are well-known predictors of stroke caused by atrial fibrillation (AF), but no studies have evaluated their use for stratifying all-cause mortality risk in patients discharged for systolic heart failure (SHF) with or without AF. This study analyzed data in the Taiwan Society of Cardiology - heart failure with reduced ejection fraction (TSOC-HFrEF) registry. These data were obtained by a prospective, multicenter, observational survey of patients treated at 21 medical centers in Taiwan after hospitalization for acute, pre-existing or new onset SHF from May, 2013 to October, 2014. During 1 year follow-up, 198 patients were lost follow-up, and final 1311 (86.8%) patients were included for further analysis. During the follow-up period, 250 (19%) patients died. Multivariate analysis revealed that body mass index, thyroid disorder, valvular surgery history, chronic kidney disease (CKD), and scores for CHADS2, CHA2 DS2- VASc, and R2 CHADS2 were significant independent predictors of mortality in the overall population of SHF patients (all P<.05) The c-indexes showed that CHADS2, CHA2 DS2 -VASc, and R2 CHADS2 scores were significantly associated with mortality in SHF patients with or without AF (all P<005). However, R2 CHADS2 had significantly higher accuracy in predicting mortality in all SHF patients compared with CHADS2 and CHA2 DS2 -VASc (DeLong test, P<.0001), especially in SHF without AF (DeLong test, P=.0003). Scores for CHADS2, CHA2 DS2 -VASc, and R2 CHADS2 can be used to predict 1-year all-cause mortality in SHF patients with or without AF. For predicting all-cause mortality in SHF patients, R 2 CHADS 2 is more accurate than CHADS2 and CHA2 DS2 -VASc.
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U2 - 10.1097/MD.0000000000008338
DO - 10.1097/MD.0000000000008338
M3 - Article
C2 - 29069008
AN - SCOPUS:85032615429
SN - 0025-7974
VL - 96
JO - Medicine (United States)
JF - Medicine (United States)
IS - 43
M1 - e8338
ER -