Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation
Purpose: Coronary artery disease (CAD) and atrial fibrillation (AF) often coexist and lead to a much higher risk of mortality in the elderly population. The aim of this study was to investigate whether the CHA2DS2-VASc score could predict the risk of death in elderly patients with CAD and AF.Methods...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.805234/full |
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| author | Yangxun Wu Yangxun Wu Guanyun Wang Guanyun Wang Lisha Dong Liu'an Qin Liu'an Qin Jian Li Hengming Yan Wenjie Guo Xiaodong Feng Yuting Zou Yuting Zou Ziqian Wang Ziqian Wang Rina Du Yuxiao Zhang Jing Ma Tong Yin Tong Yin |
| author_facet | Yangxun Wu Yangxun Wu Guanyun Wang Guanyun Wang Lisha Dong Liu'an Qin Liu'an Qin Jian Li Hengming Yan Wenjie Guo Xiaodong Feng Yuting Zou Yuting Zou Ziqian Wang Ziqian Wang Rina Du Yuxiao Zhang Jing Ma Tong Yin Tong Yin |
| author_sort | Yangxun Wu |
| collection | DOAJ |
| description | Purpose: Coronary artery disease (CAD) and atrial fibrillation (AF) often coexist and lead to a much higher risk of mortality in the elderly population. The aim of this study was to investigate whether the CHA2DS2-VASc score could predict the risk of death in elderly patients with CAD and AF.Methods: Hospitalized patients aged ≥65 years with a diagnosis of CAD and AF were recruited consecutively. Patients were divided into 5 groups according to the CHA2DS2-VASc score (≤2, =3, =4, =5, and ≥6). At least a 1-year follow-up was carried out for the assessment of all-cause death.Results: A total of 1,579 eligible patients were recruited, with 582 all-cause deaths (6.86 per 100 patient-years) occurring during a follow-up of at least 1 year. With the increase in the CHA2DS2-VASc score, the 1-year and 5-year survival rate decreased (96.4% vs. 95.7% vs. 94.0% vs. 86.5% vs. 85.7%, respectively, P < 0.001; 78.4% vs. 68.9% vs. 64.6% vs. 55.5% vs. 50.0%, respectively, P < 0.001). Compared with the patients with CHA2DS2-VASc score <5, for patients with CHA2DS2-VASc score ≥5, the adjusted hazard ratio for death was 1.78 (95% CI: 1.45–2.18, P < 0.001). The predictive values of the CHA2DS2-VASc score ≥5 for in-hospital (C-index = 0.66, 95% CI: 0.62–0.69, P < 0.001), 1-year (C-index = 0.65, 95% CI: 0.63–0.67, P < 0.001) and 5-year (C-index = 0.60, 95% CI: 0.59–0.61, P < 0.001) death were in comparable.Conclusion: In elderly patients with concomitant CAD and AF, the CHA2DS2-VASc score can be used to predict death with moderate accuracy. |
| first_indexed | 2024-12-20T13:30:07Z |
| format | Article |
| id | doaj.art-e237fab274ad419e8fe1e0c58b6546db |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-20T13:30:07Z |
| publishDate | 2021-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-e237fab274ad419e8fe1e0c58b6546db2022-12-21T19:39:07ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-12-01810.3389/fcvm.2021.805234805234Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial FibrillationYangxun Wu0Yangxun Wu1Guanyun Wang2Guanyun Wang3Lisha Dong4Liu'an Qin5Liu'an Qin6Jian Li7Hengming Yan8Wenjie Guo9Xiaodong Feng10Yuting Zou11Yuting Zou12Ziqian Wang13Ziqian Wang14Rina Du15Yuxiao Zhang16Jing Ma17Tong Yin18Tong Yin19Institute of Geriatrics, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Medical School of Chinese People's Liberation Army and Chinese People's Liberation Army General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaInstitute of Geriatrics, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Medical School of Chinese People's Liberation Army and Chinese People's Liberation Army General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaInstitute of Geriatrics, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Medical School of Chinese People's Liberation Army and Chinese People's Liberation Army General Hospital, Beijing, ChinaInstitute of Geriatrics, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Medical School of Chinese People's Liberation Army and Chinese People's Liberation Army General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaInstitute of Geriatrics, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Medical School of Chinese People's Liberation Army and Chinese People's Liberation Army General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaInstitute of Geriatrics, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Medical School of Chinese People's Liberation Army and Chinese People's Liberation Army General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaInstitute of Geriatrics, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Medical School of Chinese People's Liberation Army and Chinese People's Liberation Army General Hospital, Beijing, ChinaDepartment of Cardiology, 1st Medical Center, Medical School of Chinese PLA and Chinese PLA General Hospital, Beijing, ChinaPurpose: Coronary artery disease (CAD) and atrial fibrillation (AF) often coexist and lead to a much higher risk of mortality in the elderly population. The aim of this study was to investigate whether the CHA2DS2-VASc score could predict the risk of death in elderly patients with CAD and AF.Methods: Hospitalized patients aged ≥65 years with a diagnosis of CAD and AF were recruited consecutively. Patients were divided into 5 groups according to the CHA2DS2-VASc score (≤2, =3, =4, =5, and ≥6). At least a 1-year follow-up was carried out for the assessment of all-cause death.Results: A total of 1,579 eligible patients were recruited, with 582 all-cause deaths (6.86 per 100 patient-years) occurring during a follow-up of at least 1 year. With the increase in the CHA2DS2-VASc score, the 1-year and 5-year survival rate decreased (96.4% vs. 95.7% vs. 94.0% vs. 86.5% vs. 85.7%, respectively, P < 0.001; 78.4% vs. 68.9% vs. 64.6% vs. 55.5% vs. 50.0%, respectively, P < 0.001). Compared with the patients with CHA2DS2-VASc score <5, for patients with CHA2DS2-VASc score ≥5, the adjusted hazard ratio for death was 1.78 (95% CI: 1.45–2.18, P < 0.001). The predictive values of the CHA2DS2-VASc score ≥5 for in-hospital (C-index = 0.66, 95% CI: 0.62–0.69, P < 0.001), 1-year (C-index = 0.65, 95% CI: 0.63–0.67, P < 0.001) and 5-year (C-index = 0.60, 95% CI: 0.59–0.61, P < 0.001) death were in comparable.Conclusion: In elderly patients with concomitant CAD and AF, the CHA2DS2-VASc score can be used to predict death with moderate accuracy.https://www.frontiersin.org/articles/10.3389/fcvm.2021.805234/fullelderlyatrial fibrillationcoronary artery diseasedeathCHA2DS2-VASc score |
| spellingShingle | Yangxun Wu Yangxun Wu Guanyun Wang Guanyun Wang Lisha Dong Liu'an Qin Liu'an Qin Jian Li Hengming Yan Wenjie Guo Xiaodong Feng Yuting Zou Yuting Zou Ziqian Wang Ziqian Wang Rina Du Yuxiao Zhang Jing Ma Tong Yin Tong Yin Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation Frontiers in Cardiovascular Medicine elderly atrial fibrillation coronary artery disease death CHA2DS2-VASc score |
| title | Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation |
| title_full | Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation |
| title_fullStr | Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation |
| title_full_unstemmed | Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation |
| title_short | Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation |
| title_sort | assessment of the cha2ds2 vasc score for the prediction of death in elderly patients with coronary artery disease and atrial fibrillation |
| topic | elderly atrial fibrillation coronary artery disease death CHA2DS2-VASc score |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.805234/full |
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