Use of Preoperative CHA2DS2‐VASc Score to Predict the Risk of Atrial Fibrillation After Cardiothoracic Surgery: A Nested Case–Control Study from the Atrial Fibrillation Suppression Trials (AFIST) I, II, and III. Issue 5 (21st March 2013)

• Record Type: Journal Article
• Authors: Baker, William L; Coleman, Craig I.; White, C. Michael; Kluger, Jeffrey
• Is Part Of: Pharmacotherapy. Volume 33:Issue 5(2013)
• Page Start: 489
• Page End: 495
• Publication Date: 2013-03-21
• Subjects: Chemotherapy -- Periodicals; Pharmacology -- Periodicals; Drug Therapy -- Periodicals; Pharmacology -- Periodicals; 615.1
• DOI: 10.1002/phar.1235
• Languages: English
• ISSNs: 0277-0008

Abstract

<abstract abstract-type="main" xml:lang="en" id="phar1235-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="phar1235-sec-0001" sec-type="section"> <title>Study Objective</title> <p>To evaluate whether the preoperative CHA<sub>2</sub>DS<sub>2</sub>‐VASc score predicts the risk of atrial fibrillation (AF) after cardiothoracic surgery (CTS).</p> </sec> <sec id="phar1235-sec-0002" sec-type="section"> <title>Design</title> <p>Retrospective, nested case–control study.</p> </sec> <sec id="phar1235-sec-0003" sec-type="section"> <title>Patients</title> <p>A total of 560 patients undergoing coronary artery bypass grafting and/or valvular surgery from the Atrial Fibrillation Suppression Trials I, II, and III.</p> </sec> <sec id="phar1235-sec-0004" sec-type="section"> <title>Measurements and Main Results</title> <p>All variables showing a univariate association (p≤0.20) with AF occurrence were entered into a backward stepwise multivariate logistic regression analysis to control for potential confounders and to calculate adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The population was age 67.8 ± 8.6 (mean ± SD) years and 77.1% male, with CHA<sub>2</sub>DS<sub>2</sub>‐VASc scores of 0–1 (low) in 34 patients (6.1%), 2–3 (medium) in 261 patients (46.6%), and more than 3 (high) in 265 patients (47.3%). Post‐CTS AF occurred in 177 patients (31.6%), with 27%, 23%, and 41% in the low–, medium–, and high–CHA<sub>2</sub>DS<sub>2</sub>‐VASc score groups, respectively. The high‐score group had a 2.3‐fold increased odds of developing AF versus the medium‐score group (p<0.0001). The differences between the high‐ and medium‐score groups when each group was compared with the low‐score group were not statistically significant. On the multivariate logistic regression analysis, CHA<sub>2</sub>DS<sub>2</sub>‐VASc score was associated with development of AF (AOR 1.20, 95% CI 1.06–1.36).</p> </sec> <sec id="phar1235-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Increasing CHA<sub>2</sub>DS<sub>2</sub>‐VASc score was an independent predictor for the development of post‐CTS AF, with patients in the high‐score group having the highest overall incidence.</p> </sec> </abstract>