We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
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.
- Authors
Moonki Jung; Kyeongmin Byeon; Ki-Woon Kang; Yae Min Park; You Mi Hwang; Sung Ho Lee; Eun-Sun Jin; Seung-Young Roh; Jin Seok Kim; Jinhee Ahn; So-Ryoung Lee; Eue-Keun Choi; Min-soo Ahn; Eun Mi Lee; Hwan-Cheol Park; Ki Hong Lee; Min Kim; Joon Hyouk Choi; Jum Suk Ko; Jin Bae Kim
- Abstract
Purpose: Atrial fibrillation (AF) patients with low to intermediate risk, defined as non-gender CHA2DS2-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 CHA2DS2-VASc score 0–1. Materials and Methods: This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA2DS2-VASc score 0–1. The primary endpoint was the incidence of stroke with or without antithrombotic therapy (ATT). An ABCD score was validated. Results: 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 CHA2DS2-VASc score in the stroke risk stratification (C-index=0.618, p=0.015; net reclassification improvement=0.576, p=0.040; integrated differential improvement=0.033, p=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, p=0.003). Conclusion: The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA2DS2-VASc score 0–1. Furthermore, NOAC with an ABCD score ≥1 was associated with significantly lower stroke rate in AF patients with non-gender CHA2DS2-VASc score 0–1.
- Subjects
ATRIAL fibrillation; FIBRINOLYTIC agents; LEFT heart atrium; ORAL medication; DISEASE risk factors
- Publication
Yonsei Medical Journal, 2022, Vol 63, Issue 10, p892
- ISSN
0513-5796
- Publication type
Article
- DOI
10.3349/ymj.2022.0157