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Validation of Biomarker-Based ABCD Score in Atrial Fibrillation Patients with a Non-Gender CHA 2 DS 2 -VASc Score 0-1: A Korean Multi-Center Cohort.
- Source :
-
Yonsei medical journal [Yonsei Med J] 2022 Oct; Vol. 63 (10), pp. 892-901. - Publication Year :
- 2022
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Abstract
- Purpose: Atrial fibrillation (AF) patients with low to intermediate risk, defined as non-gender CHA <subscript>2</subscript> DS <subscript>2</subscript> -VASc score of 0-1, are still at risk of stroke. This study verified the usefulness of ABCD score [age (≥60 years), B-type natriuretic peptide (BNP) or N-terminal pro-BNP (≥300 pg/mL), creatinine clearance (<50 mL/min/1.73 m²), and dimension of the left atrium (≥45 mm)] for stroke risk stratification in non-gender CHA <subscript>2</subscript> DS <subscript>2</subscript> -VASc score 0-1.<br />Materials and Methods: This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA <subscript>2</subscript> DS <subscript>2</subscript> -VASc score 0-1. The primary endpoint was the incidence of stroke with or without antithrombotic therapy (ATT). An ABCD score was validated.<br />Results: Overall, 2694 patients [56.3±9.5 years; female, 726 (26.9%)] were followed-up for 4.0±2.8 years. The overall stroke rate was 0.84/100 person-years (P-Y), stratified as follows: 0.46/100 P-Y for an ABCD score of 0; 1.02/100 P-Y for an ABCD score ≥1. The ABCD score was superior to non-gender CHA <subscript>2</subscript> DS <subscript>2</subscript> -VASc score in the stroke risk stratification (C-index=0.618, p =0.015; net reclassification improvement=0.576, p =0.040; integrated differential improvement=0.033, p =0.066). ATT was prescribed in 2353 patients (86.5%), and the stroke rate was significantly lower in patients receiving non-vitamin K antagonist oral anticoagulant (NOAC) therapy and an ABCD score ≥1 than in those without ATT (0.44/100 P-Y vs. 1.55/100 P-Y; hazard ratio=0.26, 95% confidence interval 0.11-0.63, p =0.003).<br />Conclusion: The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA <subscript>2</subscript> DS <subscript>2</subscript> -VASc score 0-1. Furthermore, NOAC with an ABCD score ≥1 was associated with significantly lower stroke rate in AF patients with non-gender CHA <subscript>2</subscript> DS <subscript>2</subscript> -VASc score 0-1.<br />Competing Interests: The authors have no potential conflicts of interest to disclose.<br /> (© Copyright: Yonsei University College of Medicine 2022.)
- Subjects :
- Anticoagulants therapeutic use
Biomarkers
Cohort Studies
Creatinine
Female
Fibrinolytic Agents
Humans
Middle Aged
Natriuretic Peptide, Brain
Republic of Korea epidemiology
Retrospective Studies
Risk Assessment
Risk Factors
Atrial Fibrillation complications
Atrial Fibrillation drug therapy
Atrial Fibrillation epidemiology
Stroke etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1976-2437
- Volume :
- 63
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Yonsei medical journal
- Publication Type :
- Academic Journal
- Accession number :
- 36168241
- Full Text :
- https://doi.org/10.3349/ymj.2022.0157