Jung, Moonki, Byeon, Kyeongmin, Kang, Ki-Woon, Park, Yae Min, Hwang, You Mi, Lee, Sung Ho, Jin, Eun-Sun, Roh, Seung-Young, Kim, Jin Seok, Ahn, Jinhee et al (show 13 more authors)
(2022)
Validation of Biomarker-Based ABCD Score in Atrial Fibrillation Patients with a Non-Gender CHA<sub>2</sub>DS<sub>2</sub>-VASc Score 0-1: A Korean Multi-Center Cohort.
YONSEI MEDICAL JOURNAL, 63 (10).
pp. 892-901.
Abstract
<h4>Purpose</h4>Atrial fibrillation (AF) patients with low to intermediate risk, defined as non-gender CHA<sub>2</sub>DS<sub>2</sub>-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<sub>2</sub>DS<sub>2</sub>-VASc score 0-1.<h4>Materials and methods</h4>This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA<sub>2</sub>DS<sub>2</sub>-VASc score 0-1. The primary endpoint was the incidence of stroke with or without antithrombotic therapy (ATT). An ABCD score was validated.<h4>Results</h4>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<sub>2</sub>DS<sub>2</sub>-VASc score in the stroke risk stratification (C-index=0.618, <i>p</i>=0.015; net reclassification improvement=0.576, <i>p</i>=0.040; integrated differential improvement=0.033, <i>p</i>=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, <i>p</i>=0.003).<h4>Conclusion</h4>The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA<sub>2</sub>DS<sub>2</sub>-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<sub>2</sub>DS<sub>2</sub>-VASc score 0-1.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Atrial fibrillation, risk stratification, stroke, ABCD score |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 31 Jan 2023 09:05 |
| Last Modified: | 17 Mar 2024 15:19 |
| DOI: | 10.3349/ymj.2022.0157 |
| Open Access URL: | https://doi.org/10.3349/ymj.2022.0157 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3167986 |
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