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https://doi.org/10.1161/JAHA.117.006490
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Título: | Long‐term stroke risk prediction in patients with atrial fibrillation: comparison of the ABC‐stroke and CHA2DS2‐VASc scores |
Fecha de publicación: | 2017 |
Editorial: | Wiley Open Access American Heart Association |
Cita bibliográfica: | Journal of the American Heart Association. 2017;6:e006490 |
ISSN: | Electronic: 2047-9980 |
Materias relacionadas: | CDU::6 - Ciencias aplicadas::61 - Medicina |
Palabras clave: | Anticoagulantes Fibrilación auricular Biomarcadores Predicción del riesgo Ictus |
Resumen: | Background: The ABC-stroke score (age, biomarkers [N-terminal fragment B-type natriuretic peptide, high-sensitivity troponin],and clinical history [prior stroke/transient ischemic attack]) was proposed to predict stroke in atrial fibrillation (AF). This score was derived/validated in 2 clinical trial cohorts in which patients with AF were highly selected and carefully followed-up. However, the median follow-up was 1.9 years in the trial cohort; therefore, its long-term predictive performance remains uncertain. This study aimed to compare the long-term predictive performances of the ABC-stroke and CHA2DS2-VASc (cardiac failure or dysfunction, hypertension, age≥75 [doubled], diabetes mellitus, stroke [doubled]—vascular disease, age 65 to 74 years and sex category[female]) scores in a cohort of anticoagulated patients with AF. Methods and Results: We recruited 1125 consecutive patients with AF who were stable on vitamin K antagonists and followed-up for a median of 6.5 years. ABC-stroke and CHA2DS2-VASc (cardiac failure or dysfunction, hypertension, age≥75 [doubled], diabetes mellitus, stroke [doubled]—vascular disease, age 65 to 74 years and sex category [female]) scores were calculated and compared. Median CHA2DS2-VASc and ABC-stroke scores were 4 (interquartile range 3–5) and 9.1 (interquartile range 7.3–11.3), respectively. There were 114 ischemic strokes (1.55% per year) at 6.5 years. The C-index of ABC-stroke at 3.5 years was significantly higher than CHA2DS2-VASc (0.663 versus 0.600, P=0.046), but both C-indexes were nonsignificantly different at 6.5 years. Integrated discrimination improvement showed a small improvement (<2%) in sensitivity at 3.5 and 6.5 years with ABC-stroke. For ABC-stroke, net reclassification improvement was nonsignificantly different at 3.5 years, and showed a negative reclassification at 6.5 years compared with CHA2DS2-VASc. Decision curve analyses did not show a marked improvement in clinical usefulness of the ABC-stroke score over the CHA2DS2-VASc score. Conclusions: In anticoagulated patients with AF followed-up over a long-term period, the novel ABC-stroke score does not offer significantly better predictive performance compared with the CHA2DS2-VASc score. |
Autor/es principal/es: | Rivera Caravaca, José Miguel Roldán Schilling, Vanessa Esteve-Pastor, María Asunción Valdés Chávarri, Mariano Vicente García, Vicente Lip, Gregory YH Marín Ortuño, Francisco |
Facultad/Departamentos/Servicios: | Facultades, Departamentos, Servicios y Escuelas::Departamentos de la UMU::Enfermería |
URI: | http://hdl.handle.net/10201/138865 |
DOI: | https://doi.org/10.1161/JAHA.117.006490 |
Tipo de documento: | info:eu-repo/semantics/article |
Número páginas / Extensión: | 14 |
Derechos: | info:eu-repo/semantics/openAccess Attribution-NonCommercial-NoDerivatives 4.0 Internacional |
Descripción: | ª 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
Aparece en las colecciones: | Artículos: Enfermería |
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