SCORE2 and SCORE2-OP Assessment in the Predicting of Cardiovascular Diseases and AF Recurrence in Hypertensive AF Patients Who Underwent Catheter Ablation

Background/aims: Hypertension (HT) is a modifiable risk factor for the development of cardiovascular disease (CVD) in patients with atrial fibrillation (AF). There are no data on the use of the SCORE2 and SCORE2-OP risk scores used in patients with AF. In our study, we aimed to determine the effect of SCORE2 and SCORE2-OP risk scores on AF recurrence and CVD development after catheter ablation (CA) in AF patients with HT. Methods: This retrospective cohort study included 266 patients (144 men, 122 women, 57.1 ± 11 years) who underwent CA with a diagnosis of paroxysmal AF. Patients were grouped as <5%-5% to <10%-≥10% (Group I-II-III, respectively) according to CVD risk in SCORE2 and SCORE2-OP. The primary endpoint was adverse CVD. The secondary endpoint was AF recurrence. Results: The frequency of CVD and AF recurrence in groups I-II-III was 0(0%)-8(8%)-14(15%) and 9(13%)-17(16%)-23(25%), respectively (p = 0.001 and p = 0.035). Age, systolic blood pressure, presence of CVD risk ≥ 10%, CHA2DS2-VA, BUN, and uric acid were found to be higher in those with CVD. In logistic regression analysis, the presence of CVD risk ≥ 10%, CHA2DS2-VA and uric acid were found to independently predict the development of CVD (OR = 3.960, 95%CI-1.098–8.508, p = 0.019, OR = 3.257, 95%CI-1.067–7.318, p = 0.015 and OR = 1.967, 95%CI-1.359–2.873, p = 0.001). Triglycerides, CVD risk of ≥10%, and left atrial end-diastolic diameter (LAd) were found to be higher in those with AF recurrence. In regression analysis, the presence of CVD risk ≥ 10% and LAd were found to independently determine the development of AF recurrence (OR = 2.448, 95%CI-0.993–1.023, p = 0.005, OR = 1.217, 95%CI-1.124–1.319). Conclusions: SCORE2 and SCORE2-OP algorithms performed before the procedure in isolated HT patients undergoing ablation for paroxysmal AF can be used to predict AF recurrence and CVD development. The SCORE2 and SCORE2-OP algorithms have been evaluated exclusively in patients with isolated hypertension; therefore, further studies are needed to determine their applicability in the broader atrial fibrillation population.