BACKGROUND: Despite progresses in the treatment of the thromboembolic risk related to atrial fibrillation (AF), the management of recurrences remains a challenge. HYPOTHESIS: to assess if CHA2 DS2 -VASc score is predictive of early arrhythmia recurrence after AF cardioversion. METHODS: Systematic review and individual patient pooled meta-analysis following PRISMA guidelines. INCLUSION CRITERIA: observational trials in patients with AF undergoing cardioversion, available data on recurrence of AF and available data on CHA2 DS2 -VASc score. Clinical studies of interest were retrieved by PUBMED, Cochrane Library and Biomed Central. Seven authors were contacted for joining the patient level meta-analysis, and three shared data regarding anthropometric measurements, risk factors, major comorbidities, CHA2 DS2 -VASc score. The primary outcome was the recurrence of AF after cardioversion in patients free from antiarrhythmic prophylaxis. Univariate and multivariate logistic regression was performed. RESULTS: Overall we collect data of 2889 patients: 61% were male, 50% with hypertension, 12% with diabetes and 23% with history of ischemic heart disease. The median CHA2DS2-VASc score was 2 [1-3]. At the multivariate analysis, chronic kidney disease (OR 1.94; 95% CI 1.12 - 3.27; p = 0.01), peripheral artery disease (OR 1.65; 95% CI 1.23 - 2.19; p < 0,0001), previous use of beta blockers (OR 1.5; 95% CI 1.19 - 1.88; p < 0.0001), and CHA2DS2-VASc score > 2 (OR 1.37; 95% CI 1.1 - 1.68; p = 0.002) were independent predictors of early recurrence of AF. CONCLUSIONS: CHA2DS2-VASc score predicts early recurrence of AF in the first 30 days after electrical or pharmacological cardioversion. This article is protected by copyright. All rights reserved.
CHA2DS2-VASc score predicts atrial fibrillation recurrence after cardioversion: systematic review and individual patient pooled meta-analysis
Falsetti, Lorenzo;
2019
Abstract
BACKGROUND: Despite progresses in the treatment of the thromboembolic risk related to atrial fibrillation (AF), the management of recurrences remains a challenge. HYPOTHESIS: to assess if CHA2 DS2 -VASc score is predictive of early arrhythmia recurrence after AF cardioversion. METHODS: Systematic review and individual patient pooled meta-analysis following PRISMA guidelines. INCLUSION CRITERIA: observational trials in patients with AF undergoing cardioversion, available data on recurrence of AF and available data on CHA2 DS2 -VASc score. Clinical studies of interest were retrieved by PUBMED, Cochrane Library and Biomed Central. Seven authors were contacted for joining the patient level meta-analysis, and three shared data regarding anthropometric measurements, risk factors, major comorbidities, CHA2 DS2 -VASc score. The primary outcome was the recurrence of AF after cardioversion in patients free from antiarrhythmic prophylaxis. Univariate and multivariate logistic regression was performed. RESULTS: Overall we collect data of 2889 patients: 61% were male, 50% with hypertension, 12% with diabetes and 23% with history of ischemic heart disease. The median CHA2DS2-VASc score was 2 [1-3]. At the multivariate analysis, chronic kidney disease (OR 1.94; 95% CI 1.12 - 3.27; p = 0.01), peripheral artery disease (OR 1.65; 95% CI 1.23 - 2.19; p < 0,0001), previous use of beta blockers (OR 1.5; 95% CI 1.19 - 1.88; p < 0.0001), and CHA2DS2-VASc score > 2 (OR 1.37; 95% CI 1.1 - 1.68; p = 0.002) were independent predictors of early recurrence of AF. CONCLUSIONS: CHA2DS2-VASc score predicts early recurrence of AF in the first 30 days after electrical or pharmacological cardioversion. This article is protected by copyright. All rights reserved.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.