Prediction of new onset atrial fibrillation in patients with acute coronary syndrome undergoing percutaneous coronary intervention using the C2HEST and mC2HEST scores: A report from the multicenter REALE-ACS registry.

Biccirè, Flavio Giuseppe, Tanzilli, Gaetano, Prati, Francesco, Sammartini, Emanuele ORCID: 0000-0002-2873-9654, Gelfusa, Martina, Celeski, Mihail, Budassi, Simone, Barillà, Francesco, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Pastori, Daniele (2023) Prediction of new onset atrial fibrillation in patients with acute coronary syndrome undergoing percutaneous coronary intervention using the C2HEST and mC2HEST scores: A report from the multicenter REALE-ACS registry. International journal of cardiology, 386. pp. 45-49.

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Official URL: http://dx.doi.org/10.1016/j.ijcard.2023.05.023

Abstract

<h4>Background</h4>New onset atrial fibrillation (NOAF) is associated with worse clinical outcomes after acute coronary syndrome (ACS). Identification of ACS patients at risk of NOAF remains challenging. To test the value of the simple C<sub>2</sub>HEST score for predicting NOAF in patients with ACS.<h4>Methods</h4>We studied patients from the prospective ongoing multicenter REALE-ACS registry of patients with ACS. NOAF was the primary endpoint of the study. The C<sub>2</sub>HEST score was calculated as coronary artery disease or chronic obstructive pulmonary disease (1 point each), hypertension (1 point), elderly (age ≥ 75 years, 2 points), systolic heart failure (2 points), thyroid disease (1 point). We also tested the mC<sub>2</sub>HEST score.<h4>Results</h4>We enrolled 555 patients (mean age 65.6 ± 13.3 years; 22.9% women), of which 45 (8.1%) developed NOAF. Patients with NOAF were older (p < 0.001) and had more prevalent hypertension (p = 0.012), chronic obstructive pulmonary disease (p < 0.001) and hyperthyroidism (p = 0.018). Patients with NOAF were more frequently admitted with STEMI (p < 0.001), cardiogenic shock (p = 0.008), Killip class ≥2 (p < 0.001) and had higher mean GRACE score (p < 0.001). Patients with NOAF had a higher C<sub>2</sub>HEST score compared with those without (4.2 ± 1.7 vs 3.0 ± 1.5, p < 0.001). A C<sub>2</sub>HEST score > 3 was associated with NOAF occurrence (odds ratio 4.33, 95% confidence interval 2.19-8.59, p < 0.001). ROC curve analysis showed good accuracy of the C<sub>2</sub>HEST score (AUC 0.71, 95%CI 0.67-0.74) and mC<sub>2</sub>HEST score (AUC 0.69, 95%CI 065-0.73) in predicting NOAF.<h4>Conclusions</h4>The simple C<sub>2</sub>HEST score may be a useful tool to identify patients at higher risk of developing NOAF after presentation with ACS.

Item Type:	Article
Uncontrolled Keywords:	Humans, Pulmonary Disease, Chronic Obstructive, Atrial Fibrillation, Hypertension, Registries, Risk Factors, Prospective Studies, Aged, Middle Aged, Female, Male, Acute Coronary Syndrome, Percutaneous Coronary Intervention
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:	12 Oct 2023 15:55
Last Modified:	12 Oct 2023 15:56
DOI:	10.1016/j.ijcard.2023.05.023
Open Access URL:	https://doi.org/10.1016/j.ijcard.2023.05.023
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3173663