Efficacy of R2CHA2DS2-VA score for predicting thromboembolism in Thai patients with non-valvular atrial fibrillation

Abstract Background There is no data specific to the addition of renal dysfunction and age 50–64 years as risk parameters to the CHA2DS2-VA score, which is known as the R2CHA2DS2-VA score, among NVAF patients. Accordingly, the aim of this study was to validate the R2CHA2DS2-VA score for predicting t...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Komsing Methavigul, Poom Sairat, Rungroj Krittayaphong, for the COOL-AF Investigators
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	R2CHA2DS2-VA CHA2DS2-VASc Thromboembolism Non-valvular atrial fibrillation NVAF Anticoagulant Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/9821754e7adc46fa91999606bcb1cf66
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:9821754e7adc46fa91999606bcb1cf66
record_format	dspace
spelling	oai:doaj.org-article:9821754e7adc46fa91999606bcb1cf662021-11-14T12:07:32ZEfficacy of R2CHA2DS2-VA score for predicting thromboembolism in Thai patients with non-valvular atrial fibrillation10.1186/s12872-021-02370-21471-2261https://doaj.org/article/9821754e7adc46fa91999606bcb1cf662021-11-01T00:00:00Zhttps://doi.org/10.1186/s12872-021-02370-2https://doaj.org/toc/1471-2261Abstract Background There is no data specific to the addition of renal dysfunction and age 50–64 years as risk parameters to the CHA2DS2-VA score, which is known as the R2CHA2DS2-VA score, among NVAF patients. Accordingly, the aim of this study was to validate the R2CHA2DS2-VA score for predicting thromboembolism in Thai NVAF patients. Methods Thai NVAF patients were prospectively enrolled in a nationwide multicenter registry from 27 hospitals during 2014–2020. Each component of the CHA2DS2-VA and R2CHA2DS2-VA scores was scored and recorded. The main outcomes were thromboembolism, including ischemic stroke, transient ischemic attack (TIA), and/or systemic embolism. The annual incidence rate of thromboembolism among patients in each R2CHA2DS2-VA and CHA2DS2-VA risk score category is shown as hazard ratio (HR) and 95% confidence interval (95% CI). The performance of the R2CHA2DS2-VA and CHA2DS2-VA scores was demonstrated using c-statistics. Net reclassification index was calculated. Calibration plat was used to assess agreement between observed probabilities and predicted probabilities of both scoring system. Results A total of 3402 patients were enrolled during 2014–2020. The average age of patients was 67.38 ± 11.27 years. Of those, 46.9% had renal disease, 30.7% had a history of heart failure, and 17.1% had previous stroke or TIA. The average R2CHA2DS2-VA and CHA2DS2-VA scores were 3.92 ± 1.92 and 2.98 ± 1.43, respectively. Annual thromboembolic risk increased with incremental increase in R2CHA2DS2-VA and CHA2DS2-VA scores. Oral anticoagulants had benefit in stroke prevention in NVAF patients with an R2CHA2DS2-VA score of 2 or more (adjusted HR: 0.630, 95% CI 0.413–0.962, p = 0.032). The c-statistics were 0.630 (95% CI 0.61–0.65) and 0.627 (95% CI 0.61–0.64), for R2CHA2DS2-VA and CHA2DS2-VA scores respectively. NRI was 2.2%. The slope and R2 of the calibration plot were 0.73 and 0.905 for R2CHA2DS2-VA and 0.70 and 0.846 for CHA2DS2-VA score respectively. Conclusions R2CHA2DS2-VA score was found to be at least as good as CHA2DS2-VA score for predicting thromboembolism in Thai patients with NVAF. Similar to CHA2DS2-VA score, thromboembolism increased with incremental increase in R2CHA2DS2-VA score.Komsing MethavigulPoom SairatRungroj Krittayaphongfor the COOL-AF InvestigatorsBMCarticleR2CHA2DS2-VACHA2DS2-VAScThromboembolismNon-valvular atrial fibrillationNVAFAnticoagulantDiseases of the circulatory (Cardiovascular) systemRC666-701ENBMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	R2CHA2DS2-VA CHA2DS2-VASc Thromboembolism Non-valvular atrial fibrillation NVAF Anticoagulant Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	R2CHA2DS2-VA CHA2DS2-VASc Thromboembolism Non-valvular atrial fibrillation NVAF Anticoagulant Diseases of the circulatory (Cardiovascular) system RC666-701 Komsing Methavigul Poom Sairat Rungroj Krittayaphong for the COOL-AF Investigators Efficacy of R2CHA2DS2-VA score for predicting thromboembolism in Thai patients with non-valvular atrial fibrillation
description	Abstract Background There is no data specific to the addition of renal dysfunction and age 50–64 years as risk parameters to the CHA2DS2-VA score, which is known as the R2CHA2DS2-VA score, among NVAF patients. Accordingly, the aim of this study was to validate the R2CHA2DS2-VA score for predicting thromboembolism in Thai NVAF patients. Methods Thai NVAF patients were prospectively enrolled in a nationwide multicenter registry from 27 hospitals during 2014–2020. Each component of the CHA2DS2-VA and R2CHA2DS2-VA scores was scored and recorded. The main outcomes were thromboembolism, including ischemic stroke, transient ischemic attack (TIA), and/or systemic embolism. The annual incidence rate of thromboembolism among patients in each R2CHA2DS2-VA and CHA2DS2-VA risk score category is shown as hazard ratio (HR) and 95% confidence interval (95% CI). The performance of the R2CHA2DS2-VA and CHA2DS2-VA scores was demonstrated using c-statistics. Net reclassification index was calculated. Calibration plat was used to assess agreement between observed probabilities and predicted probabilities of both scoring system. Results A total of 3402 patients were enrolled during 2014–2020. The average age of patients was 67.38 ± 11.27 years. Of those, 46.9% had renal disease, 30.7% had a history of heart failure, and 17.1% had previous stroke or TIA. The average R2CHA2DS2-VA and CHA2DS2-VA scores were 3.92 ± 1.92 and 2.98 ± 1.43, respectively. Annual thromboembolic risk increased with incremental increase in R2CHA2DS2-VA and CHA2DS2-VA scores. Oral anticoagulants had benefit in stroke prevention in NVAF patients with an R2CHA2DS2-VA score of 2 or more (adjusted HR: 0.630, 95% CI 0.413–0.962, p = 0.032). The c-statistics were 0.630 (95% CI 0.61–0.65) and 0.627 (95% CI 0.61–0.64), for R2CHA2DS2-VA and CHA2DS2-VA scores respectively. NRI was 2.2%. The slope and R2 of the calibration plot were 0.73 and 0.905 for R2CHA2DS2-VA and 0.70 and 0.846 for CHA2DS2-VA score respectively. Conclusions R2CHA2DS2-VA score was found to be at least as good as CHA2DS2-VA score for predicting thromboembolism in Thai patients with NVAF. Similar to CHA2DS2-VA score, thromboembolism increased with incremental increase in R2CHA2DS2-VA score.
format	article
author	Komsing Methavigul Poom Sairat Rungroj Krittayaphong for the COOL-AF Investigators
author_facet	Komsing Methavigul Poom Sairat Rungroj Krittayaphong for the COOL-AF Investigators
author_sort	Komsing Methavigul
title	Efficacy of R2CHA2DS2-VA score for predicting thromboembolism in Thai patients with non-valvular atrial fibrillation
title_short	Efficacy of R2CHA2DS2-VA score for predicting thromboembolism in Thai patients with non-valvular atrial fibrillation
title_full	Efficacy of R2CHA2DS2-VA score for predicting thromboembolism in Thai patients with non-valvular atrial fibrillation
title_fullStr	Efficacy of R2CHA2DS2-VA score for predicting thromboembolism in Thai patients with non-valvular atrial fibrillation
title_full_unstemmed	Efficacy of R2CHA2DS2-VA score for predicting thromboembolism in Thai patients with non-valvular atrial fibrillation
title_sort	efficacy of r2cha2ds2-va score for predicting thromboembolism in thai patients with non-valvular atrial fibrillation
publisher	BMC
publishDate	2021
url	https://doaj.org/article/9821754e7adc46fa91999606bcb1cf66
work_keys_str_mv	AT komsingmethavigul efficacyofr2cha2ds2vascoreforpredictingthromboembolisminthaipatientswithnonvalvularatrialfibrillation AT poomsairat efficacyofr2cha2ds2vascoreforpredictingthromboembolisminthaipatientswithnonvalvularatrialfibrillation AT rungrojkrittayaphong efficacyofr2cha2ds2vascoreforpredictingthromboembolisminthaipatientswithnonvalvularatrialfibrillation AT forthecoolafinvestigators efficacyofr2cha2ds2vascoreforpredictingthromboembolisminthaipatientswithnonvalvularatrialfibrillation
_version_	1718429419000823808

Efficacy of R2CHA2DS2-VA score for predicting thromboembolism in Thai patients with non-valvular atrial fibrillation

Ejemplares similares