The CHA2DS2-VASc Score and Its Association with Long-Term Outcome in a Cardiac Resynchronization Therapy Population
Reitan, Christian LU ; Platonov, Pyotr G. LU and Borgquist, Rasmus LU
(2021)
In Cardiology
146(4).
p.453-463
- Abstract
Background: Cardiac resynchronization therapy (CRT) is commonly used in patients with heart failure and left ventricular dyssynchrony. Several scoring systems have been tested in order to predict long-term outcome. Although intended for use in patients with atrial fibrillation, we sought to assess the performance of the CHA2DS2-VASc score in a CRT population. Methods: Data on 796 consecutive CRT patients were retrospectively gathered from hospital records and healthcare registries. CHA2DS2-VASc scores were calculated, as well as other stratification scores for comparison. The outcomes were crude mortality, time to first heart failure hospitalization, and a composite of the 2.... (More)
Background: Cardiac resynchronization therapy (CRT) is commonly used in patients with heart failure and left ventricular dyssynchrony. Several scoring systems have been tested in order to predict long-term outcome. Although intended for use in patients with atrial fibrillation, we sought to assess the performance of the CHA2DS2-VASc score in a CRT population. Methods: Data on 796 consecutive CRT patients were retrospectively gathered from hospital records and healthcare registries. CHA2DS2-VASc scores were calculated, as well as other stratification scores for comparison. The outcomes were crude mortality, time to first heart failure hospitalization, and a composite of the 2. CHA2DS2-VASc score was evaluated against the end points with survival analyses and compared to other risk stratification scores. Results: The CHA2DS2-VASc score was significantly correlated with both outcomes in univariable and multivariable analysis adjusting for other known predictors of CRT outcome (unadjusted HR 1.28, 95% CI 1.21-1.36 and HR 1.19, 95% CI 1.13-1.25 for the mortality and heart failure hospitalization end points, respectively). Its performance compared well to other validated scores for the mortality end point (Harrell's C: 0.61, range for other scoring systems: 0.57-0.65), as well as the heart failure hospitalization end point (Harrell's C: 0.57, range of other scoring systems: 0.58-0.62). It correlated to 5- and 10-year survival with an area under the curve of 0.63 and 0.73, respectively. Conclusion: When tested for association with outcome in a CRT population, the CHA2DS2-VASc score correlates to increased mortality and risk of heart failure hospitalization. It performs similarly to CRT-specific scores. However, the results of this study indicate that all tested scores should be used with caution in CRT patients.
(Less)
- author
- Reitan, Christian
LU
; Platonov, Pyotr G.
LU
and Borgquist, Rasmus
LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac resynchronization therapy, Long-term outcome, Mortality, Risk stratification, Score
- in
- Cardiology
- volume
- 146
- issue
- 4
- pages
- 453 - 463
- publisher
- Karger
- external identifiers
-
- pmid:33965960
- scopus:85107477697
- ISSN
- 0008-6312
- DOI
- 10.1159/000513955
- language
- English
- LU publication?
- yes
- id
- 8f3022ed-c052-4d6e-84c3-051497b130f6
- date added to LUP
- 2021-07-09 14:20:15
- date last changed
- 2024-03-23 06:42:23
@article{8f3022ed-c052-4d6e-84c3-051497b130f6,
abstract = {{<p>Background: Cardiac resynchronization therapy (CRT) is commonly used in patients with heart failure and left ventricular dyssynchrony. Several scoring systems have been tested in order to predict long-term outcome. Although intended for use in patients with atrial fibrillation, we sought to assess the performance of the CHA<sub>2</sub>DS<sub>2</sub>-VASc score in a CRT population. Methods: Data on 796 consecutive CRT patients were retrospectively gathered from hospital records and healthcare registries. CHA<sub>2</sub>DS<sub>2</sub>-VASc scores were calculated, as well as other stratification scores for comparison. The outcomes were crude mortality, time to first heart failure hospitalization, and a composite of the 2. CHA<sub>2</sub>DS<sub>2</sub>-VASc score was evaluated against the end points with survival analyses and compared to other risk stratification scores. Results: The CHA<sub>2</sub>DS<sub>2</sub>-VASc score was significantly correlated with both outcomes in univariable and multivariable analysis adjusting for other known predictors of CRT outcome (unadjusted HR 1.28, 95% CI 1.21-1.36 and HR 1.19, 95% CI 1.13-1.25 for the mortality and heart failure hospitalization end points, respectively). Its performance compared well to other validated scores for the mortality end point (Harrell's C: 0.61, range for other scoring systems: 0.57-0.65), as well as the heart failure hospitalization end point (Harrell's C: 0.57, range of other scoring systems: 0.58-0.62). It correlated to 5- and 10-year survival with an area under the curve of 0.63 and 0.73, respectively. Conclusion: When tested for association with outcome in a CRT population, the CHA<sub>2</sub>DS<sub>2</sub>-VASc score correlates to increased mortality and risk of heart failure hospitalization. It performs similarly to CRT-specific scores. However, the results of this study indicate that all tested scores should be used with caution in CRT patients. </p>}},
author = {{Reitan, Christian and Platonov, Pyotr G. and Borgquist, Rasmus}},
issn = {{0008-6312}},
keywords = {{Cardiac resynchronization therapy; Long-term outcome; Mortality; Risk stratification; Score}},
language = {{eng}},
number = {{4}},
pages = {{453--463}},
publisher = {{Karger}},
series = {{Cardiology}},
title = {{The CHA<sub>2</sub>DS<sub>2</sub>-VASc Score and Its Association with Long-Term Outcome in a Cardiac Resynchronization Therapy Population}},
url = {{http://dx.doi.org/10.1159/000513955}},
doi = {{10.1159/000513955}},
volume = {{146}},
year = {{2021}},
}