Utility of the CHA
2DS
2-VASc Score in Prediction of Postoperative Atrial Fibrillation After Coronary Artery Bypass Graft Surgery.
J Cardiothorac Vasc Anesth 2021;
36:1304-1309. [PMID:
34384685 DOI:
10.1053/j.jvca.2021.07.028]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/28/2021] [Accepted: 07/11/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE
The authors aimed to investigate the role of CHA2DS2-VASc score and its components in prediction of postoperative atrial fibrillation (POAF) after isolated coronary artery bypass graft (CABG) surgery.
DESIGN
Retrospective cohort.
SETTING
Single-center university-affiliated tertiary cardiac center.
PARTICIPANTS
A total of 2,981 consecutive patients who underwent isolated CABG between 2010 and 2012 were included.
INTERVENTIONS
All patients underwent isolated CABG and were followed until discharge or in-hospital death. The primary outcome was the development of new-onset POAF during the hospital course.
MEASUREMENTS AND MAIN RESULTS
During hospitalization, continuous electrocardiogram monitoring was used to detect POAF episodes. New-onset POAF developed in 15.8% of patients following isolated CABG. Patients with POAF had significantly higher CHA2DS2-VASc scores than those without POAF (2.66 ± 1.51 v 2.12 ± 1.36, p < 0.001). After adjustment for potential confounders, CHA2DS2-VASc score was significantly associated with POAF (odds ratio [OR]: 1.295, 95% CI: 1.205-1.391). However, further analyses showed that this effect was restricted to patients with a CHA2DS2-VASc score of ≥2 (OR: 1.813, 95% CI: 1.220-2.694). In multivariate analysis of the CHA2DS2-VASc components, age ≥75 (OR: 3.737, 95% CI: 2.702-5.168), age 65 to 74 (OR: 2.126, 1.701-2.658), hypertension (OR: 1.310, 95% CI: 1.051-1.633), and cerebrovascular accident (OR: 1.807, 95% CI: 1.197-2.726) were independent predictors of POAF. However, the association between POAF and female sex, diabetes mellitus, congestive heart failure, and vascular disease was not statistically significant.
CONCLUSIONS
CHA2DS2-VASc score is a useful tool for the prediction of POAF after isolated CABG. However, the risk should be interpreted cautiously, since the risk score's promising effect relies on only several of its components.
Collapse