Wang, Yu-Feng, Jiang, Chao 
ORCID: 0000-0003-1138-7960, He, Liu, Du, Xin, Guo, Xue-Yuan, Tang, Ri-Bo, Sang, Cai-Hua, Long, De-Yong, Dong, Jian-Zeng, Lip, Gregory YH ORCID: 0000-0002-7566-1626 et al (show 1 more authors)
(2023)
The ABC-Death Score for Mortality Prediction in Patients With Atrial Fibrillation Undergoing Catheter Ablation.
JACC. Asia, 3 (5).
pp. 790-801.
Abstract
<h4>Background</h4>Data on the performance of risk scores in predicting mortality risk after atrial fibrillation (AF) ablations are limited.<h4>Objectives</h4>The purpose of this study was to investigate the associations of mortality with preablation biomarkers and evaluate the performance of age, biomarker, and clinical history (ABC)-death score in patients with AF undergoing catheter ablation.<h4>Methods</h4>Patients with AF undergoing catheter ablations between 2013 and 2019 in the Chinese Atrial Fibrillation Registry were enrolled. Biomarkers associated with ABC-death score were quantified from baseline blood samples collected before AF ablation. Clinical outcomes were all-cause mortality and cardiac mortality. Discrimination, reclassification, clinical use, and calibration were further evaluated.<h4>Results</h4>We identified 4,218 patients with AF undergoing catheter ablations. During a median follow-up period of 4.0 years, 119 patients died due to all causes, with 49 dying due to cardiac causes. Biomarker levels were all independently associated with an increased risk of all-cause death and cardiac death. The ABC-death score was superior to the CHA<sub>2</sub>DS<sub>2</sub>-VASc score in predicting all-cause death (C index 0.73 vs 0.63; <i>P</i> = 0.001) and cardiac death (C index 0.83 vs 0.71; <i>P</i> = 0.007). Reclassification analysis revealed significant reclassification improvements of the ABC-death score compared with the CHA<sub>2</sub>DS<sub>2</sub>-VASc (cardiac failure or dysfunction, hypertension, age ≥75 [doubled], diabetes mellitus, stroke [doubled]-vascular disease, age 65 to 74 years and sex category [female]) score. Decision curve analysis showed the greater net benefit of use of the ABC-death score. Calibration plots presented an overestimation of the observed mortality event rate by ABC-death score.<h4>Conclusions</h4>Preablation biomarkers associated with ABC-death score were independently related to increased all-cause and cardiac mortality risk. Despite the overestimation of the event rate, the ABC-death score outperformed the CHA<sub>2</sub>DS<sub>2</sub>-VASc score in discriminating and reclassifying mortality risk, especially for cardiac mortality.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ABC-death score, atrial fibrillation, biomarker, catheter ablation, mortality |
| 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: | 09 Apr 2024 10:06 |
| Last Modified: | 09 Apr 2024 14:27 |
| DOI: | 10.1016/j.jacasi.2023.07.007 |
| Open Access URL: | https://doi.org/10.1016/j.jacasi.2023.07.007 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3180218 |
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