Higher CHADS2 scores were independently associated with an increased risk of atrial fibrillation recurrence (OR 1.45) and progression to chronic atrial fibrillation during antiarrhythmic drug therapy.
Observational (n=459)
No
Does the CHADS2 score predict the efficacy of antiarrhythmic drug therapy in patients with paroxysmal atrial fibrillation?
The CHADS2 score is a useful clinical tool for predicting the efficacy of antiarrhythmic drug therapy and the risk of progression to chronic AF in patients with paroxysmal atrial fibrillation.
Odds Ratio: 1.45 (95% CI 1.16–1.81)
p-value: p=<0.001
BACKGROUND: The Cardiac failure, Hypertension, Age, Diabetes, Stroke Doubled (CHADS(2)) score is a useful scheme for risk stratification of thromboembolism patients, but there is little information about its usefulness for the evaluation of antiarrhythmic drug (AAD) therapy. METHODS AND RESULTS: This study included 459 paroxysmal atrial fibrillation (AF) patients (309 men, mean age 66 ± 12 years, mean follow-up 50 ± 35 months) and prophylactic efficacy was analyzed on the basis of CHADS(2) score. (1) Survival rates free from AF recurrence at 1, 6, 12 and 24 months were, respectively, 89%, 74%, 63% and 47% in score-0 group (n=152); 92%, 68%, 59% and 48% in score-1 group (n=158); 86%, 64%, 56% and 46% in score-2 group (n=84); 81%, 65%, 51% and 35% in score-3 group (n=43); and 68%, 50%, 36% and 18% in ≥ score-4 group (n=22) (P<0.05; score-0, score-1 or score-2 vs. ≥ score-4 group). (2) Survival rates free from progression to chronic AF at 12, 36, 60 and 90 months were, respectively, 95%, 93%, 91% and 89% in score-0 group; 97%, 91%, 89% and 88% in score-1 group; 96%, 93%, 88% and 83% in score-2 group; 91%, 74%, 67% and 60% in score-3 group; and 91%, 82%, 68% and 55% in ≥ score-4 group (P<0.01; score-0, score-1 or score-2 vs. ≥ score-4 group). (3) In multivariate logistic regression analysis adjusted for potentially confounding variables, CHADS(2) score was associated with AF recurrence (odds ratio OR 1.45, 95% confidence interval CI 1.16-1.81, P<0.001), and progression to chronic AF during AAD therapy (OR 1.64, 95% CI 1.04-2.69, P<0.001). CONCLUSIONS: When using a rhythm control strategy, the CHADS(2) score is a useful scheme for predicting the outcome of AAD treatment of patients with paroxysmal AF.
Komatsu et al. (Wed,) conducted a observational in Paroxysmal atrial fibrillation (n=459). CHADS2 score vs. Lower CHADS2 score was evaluated on Atrial fibrillation recurrence (OR 1.45, 95% CI 1.16-1.81, p=<0.001). Higher CHADS2 scores were independently associated with an increased risk of atrial fibrillation recurrence (OR 1.45) and progression to chronic atrial fibrillation during antiarrhythmic drug therapy.