What does this research mean for the field?

A CHA2DS2-VASc score ≥3 increases the odds of incident atrial fibrillation by 2.57-fold compared to a score <3 in hypertensive patients, and coexisting left atrial dilatation further identifies high-risk subjects. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 27, 2019Scientific ReportsOpen Access

A CHA2DS2-VASc score ≥3 increased the odds of incident atrial fibrillation by 2.57-fold compared to a score <3 in hypertensive patients.

Q: What are the key findings of this study?

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Arterial hypertension (n=6597). Intervention: High CHA2DS2-VASc score (≥3) vs. Low-moderate CHA2DS2-VASc score (<3). Primary outcome: Incident atrial fibrillation (OR 2.57, 95% CI 1.71-4.86, p=<0.0001).

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Why the study?

Whether the CHA2DS2-VASc score predicts incident atrial fibrillation and how it interacts with left atrial dilatation in hypertensive patients is unknown.

Does a high CHA2DS2-VASc score predict incident atrial fibrillation in hypertensive patients?

Population

Hypertensive patients from a registry without prevalent AF, low EF, or missing follow-up/carotid ultrasound

Comparison

CHA2DS2-VASc score ≥3 vs score ≤2

Design

Observational registry study

Follow-up

Median = 54 months

Key result

A CHA2DS2-VASc score ≥3 increased the odds of incident atrial fibrillation by 2.57-fold compared to a score <3 in hypertensive patients.

Authors

ARAntonio Rapacciuolo CMCostantino Mancusi GCGrazia Canciello

Discussion

Member takes

Overview

Supports CHA2DS2-VASc for AF risk stratification in hypertension; hypothesis-generating for targeted screening pending prospective trials.

Study Design

Type

Observational (n=6,597)

Multicenter

Yes

Structured PICO

Does a high CHA2DS2-VASc score predict incident atrial fibrillation in hypertensive patients?

Population

6,597 hypertensive patients from the Campania Salute Network registry (excluding those with prevalent atrial fibrillation, without follow-up, without carotid ultrasound, or with left ventricular ejection fraction <50%)

Intervention

CHA2DS2-VASc score ≥3

Comparator

CHA2DS2-VASc score <3

Outcome

Incident symptomatic or occasionally detected atrial fibrillationhard clinical

Main Result

Effect estimate: OR 2.57 (95% CI 1.71-4.86)

Absolute Event Rate: 8.8% vs 4.4%

p-value: p=<0.0001

In hypertensive patients, a CHA2DS2-VASc score ≥3 and left atrial dilatation synergistically predict the incidence of atrial fibrillation, identifying a high-risk population that may benefit from more aggressive management.

Limitations

Some episodes of asymptomatic or silent atrial fibrillation may not have been detected or censored.
Observational design limits the ability to establish causality, serving primarily as hypothesis-generating.
Not all patients with ascertained AF episodes were symptomatic and went to hospital settings, so some episodes could not be censored
Hypothesis generating study requiring ad hoc studies to establish actual incidence and need for anticoagulant therapy

Cite This Study

Rapacciuolo et al. (2019) conducted an observational in Arterial hypertension (n=6,597). High CHA2DS2-VASc score (≥3) vs. Low-moderate CHA2DS2-VASc score (<3) was evaluated on Incident atrial fibrillation (OR 2.57, 95% CI 1.71-4.86, p=<0.0001). A CHA2DS2-VASc score ≥3 increased the odds of incident atrial fibrillation by 2.57-fold compared to a score <3 in hypertensive patients.

synapsesocial.com/papers/6a12b5eeb8b0b51fb9a4200a https://doi.org/10.1038/s41598-019-44214-2

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May 27, 2019Scientific ReportsOpen Access

A CHA2DS2-VASc score ≥3 increased the odds of incident atrial fibrillation by 2.57-fold compared to a score <3 in hypertensive patients.

View Full Paper

Ask AI

Bookmark

Why the study?

Whether the CHA2DS2-VASc score predicts incident atrial fibrillation and how it interacts with left atrial dilatation in hypertensive patients is unknown.

Does a high CHA2DS2-VASc score predict incident atrial fibrillation in hypertensive patients?

Population

Hypertensive patients from a registry without prevalent AF, low EF, or missing follow-up/carotid ultrasound

Comparison

CHA2DS2-VASc score ≥3 vs score ≤2

Design

Observational registry study

Follow-up

Median = 54 months

Key result

A CHA2DS2-VASc score ≥3 increased the odds of incident atrial fibrillation by 2.57-fold compared to a score <3 in hypertensive patients.

Authors

ARAntonio Rapacciuolo CMCostantino Mancusi GCGrazia Canciello

Discussion

Member takes

Overview

Supports CHA2DS2-VASc for AF risk stratification in hypertension; hypothesis-generating for targeted screening pending prospective trials.

Study Design

Type

Observational (n=6,597)

Multicenter

Yes

Structured PICO

Does a high CHA2DS2-VASc score predict incident atrial fibrillation in hypertensive patients?

Population

Intervention

CHA2DS2-VASc score ≥3

Comparator

CHA2DS2-VASc score <3

Outcome

Incident symptomatic or occasionally detected atrial fibrillationhard clinical

Main Result

Effect estimate: OR 2.57 (95% CI 1.71-4.86)

Absolute Event Rate: 8.8% vs 4.4%

p-value: p=<0.0001

Limitations

Some episodes of asymptomatic or silent atrial fibrillation may not have been detected or censored.
Observational design limits the ability to establish causality, serving primarily as hypothesis-generating.
Not all patients with ascertained AF episodes were symptomatic and went to hospital settings, so some episodes could not be censored
Hypothesis generating study requiring ad hoc studies to establish actual incidence and need for anticoagulant therapy

Cite This Study

synapsesocial.com/papers/6a12b5eeb8b0b51fb9a4200a https://doi.org/10.1038/s41598-019-44214-2

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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