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Long‐term stroke risk prediction in patients with atrial fibrillation: comparison of the ABC‐stroke and CHA2DS2‐VASc scores

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dc.contributor.authorRivera Caravaca, José Miguel
dc.contributor.authorRoldán Schilling, Vanessa
dc.contributor.authorEsteve-Pastor, María Asunción
dc.contributor.authorValdés Chávarri, Mariano
dc.contributor.authorVicente García, Vicente
dc.contributor.authorLip, Gregory YH
dc.contributor.authorMarín Ortuño, Francisco
dc.contributor.departmentEnfermería
dc.date.accessioned2024-02-07T09:51:13Z
dc.date.available2024-02-07T09:51:13Z
dc.date.issued2017
dc.descriptionª 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
dc.description.abstractBackground: The ABC-stroke score (age, biomarkers [N-terminal fragment B-type natriuretic peptide, high-sensitivity troponin],and clinical history [prior stroke/transient ischemic attack]) was proposed to predict stroke in atrial fibrillation (AF). This score was derived/validated in 2 clinical trial cohorts in which patients with AF were highly selected and carefully followed-up. However, the median follow-up was 1.9 years in the trial cohort; therefore, its long-term predictive performance remains uncertain. This study aimed to compare the long-term predictive performances of the ABC-stroke and CHA2DS2-VASc (cardiac failure or dysfunction, hypertension, age≥75 [doubled], diabetes mellitus, stroke [doubled]—vascular disease, age 65 to 74 years and sex category[female]) scores in a cohort of anticoagulated patients with AF. Methods and Results: We recruited 1125 consecutive patients with AF who were stable on vitamin K antagonists and followed-up for a median of 6.5 years. ABC-stroke and CHA2DS2-VASc (cardiac failure or dysfunction, hypertension, age≥75 [doubled], diabetes mellitus, stroke [doubled]—vascular disease, age 65 to 74 years and sex category [female]) scores were calculated and compared. Median CHA2DS2-VASc and ABC-stroke scores were 4 (interquartile range 3–5) and 9.1 (interquartile range 7.3–11.3), respectively. There were 114 ischemic strokes (1.55% per year) at 6.5 years. The C-index of ABC-stroke at 3.5 years was significantly higher than CHA2DS2-VASc (0.663 versus 0.600, P=0.046), but both C-indexes were nonsignificantly different at 6.5 years. Integrated discrimination improvement showed a small improvement (<2%) in sensitivity at 3.5 and 6.5 years with ABC-stroke. For ABC-stroke, net reclassification improvement was nonsignificantly different at 3.5 years, and showed a negative reclassification at 6.5 years compared with CHA2DS2-VASc. Decision curve analyses did not show a marked improvement in clinical usefulness of the ABC-stroke score over the CHA2DS2-VASc score. Conclusions: In anticoagulated patients with AF followed-up over a long-term period, the novel ABC-stroke score does not offer significantly better predictive performance compared with the CHA2DS2-VASc score.es
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dc.format.extent14es
dc.identifier.citationJournal of the American Heart Association. 2017 6:e006490
dc.identifier.doihttps://doi.org/10.1161/JAHA.117.006490
dc.identifier.issnElectronic: 2047-9980
dc.identifier.urihttp://hdl.handle.net/10201/138865
dc.languageenges
dc.publisherWiley Open Access
dc.publisherAmerican Heart Association
dc.relationInstituto de Salud Carlos III (ISCIII) (PI13/00513 y P14/00253), Fundación Séneca (19245/PI/14), RD12/0042/0050, e Instituto Murciano de Investigación Biosanitaria (IMIB16/AP/01/06)es
dc.rightsinfo:eu-repo/semantics/openAccesses
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectAnticoagulanteses
dc.subjectFibrilación auriculares
dc.subjectBiomarcadoreses
dc.subjectPredicción del riesgoes
dc.subjectIctuses
dc.subject.otherCDU::6 - Ciencias aplicadas::61 - Medicinaes
dc.titleLong‐term stroke risk prediction in patients with atrial fibrillation: comparison of the ABC‐stroke and CHA2DS2‐VASc scoreses
dc.typeinfo:eu-repo/semantics/articlees
dspace.entity.typePublicationes
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