Improving Stroke Risk Stratification Using the CHADS2 and CHA2DS2-VASc Risk Scores in Patients With Paroxysmal Atrial Fibrillation by Continuous Arrhythmia Burden Monitoring
In patients with atrial fibrillation (AF), stroke risk stratification schema do not consider AF parameters. The aim of the study is to assess the impact of combining risk factors with continuous AF burden monitoring. In this retrospective study 568 patients implanted with a DDDR-P pacemaker (AT-500;...
Gespeichert in:
| Veröffentlicht in: | Stroke (1970) 2011-06, Vol.42 (6), p.1768-1770 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1770 |
|---|---|
| container_issue | 6 |
| container_start_page | 1768 |
| container_title | Stroke (1970) |
| container_volume | 42 |
| creator | BORIANI, Giuseppe LUCA BOTTO, Giovanni LIP, Gregory Y. H PADELETTI, Luigi SANTINI, Massimo CAPUCCI, Alessandro GULIZIA, Michele RICCI, Renato BIFFI, Mauro DE SANTO, Tiziana CORBUCCI, Giorgio |
| description | In patients with atrial fibrillation (AF), stroke risk stratification schema do not consider AF parameters. The aim of the study is to assess the impact of combining risk factors with continuous AF burden monitoring.
In this retrospective study 568 patients implanted with a DDDR-P pacemaker (AT-500; Medtronic) and a history of AF were continuously monitored for 1 year.
During follow-up, 14 patients (2.5%) had a thromboembolic event. Patients were divided into 3 groups: AF burden ≤5 minutes per day (AF-free; n=223 [39%]), AF burden >5 minutes but |
| doi_str_mv | 10.1161/STROKEAHA.110.609297 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_878031984</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>878031984</sourcerecordid><originalsourceid>FETCH-LOGICAL-c206t-7021a29c0f242a8c60f315c1b58f5c44615a941183a8b1dce63609ddc3da557d3</originalsourceid><addsrcrecordid>eNpFkEtP4zAUhS00CMrjH4xG3oxYBfxM7WUojyJAIArMsnIcZ2pIbLAdRH8U_xFXFLG59xzpu1dHB4DfGB1iXOKj2f3dzeVpNa2yRYclkkSON8AIc8IKVhLxC4wQorIgTMptsBPjE0KIUMG3wDbBTFKJ2Ah8XPQvwb9Z9x_OUvDPBt7Z-LzSKtnW6jy9gw9xBaSFgZNpdTIjULlmJUnWxWM10-sr7YOJ0Dp4m--MSxH-s2mRXfDvy9irDlYp2LzObB1s1319r5dw4l2ybvBDhFUIi2Va9FbB4yE0xsFr72zyIUfYA5ut6qLZX-9d8HB2ej-ZFlc35xeT6qrQBJWpGCOCFZEatYQRJXSJWoq5xjUXLdeMlZgryTAWVIkaN9qUNPfXNJo2ivNxQ3fBwdff3M3rYGKa9zZqkwM7kzPOxVggiqVgmfyzJoe6N838JdheheX8u-EM_F0DKmrVtUE5beMPxwinomT0EwZ_jQY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>878031984</pqid></control><display><type>article</type><title>Improving Stroke Risk Stratification Using the CHADS2 and CHA2DS2-VASc Risk Scores in Patients With Paroxysmal Atrial Fibrillation by Continuous Arrhythmia Burden Monitoring</title><source>MEDLINE</source><source>American Heart Association Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Journals@Ovid Ovid Autoload</source><source>Alma/SFX Local Collection</source><creator>BORIANI, Giuseppe ; LUCA BOTTO, Giovanni ; LIP, Gregory Y. H ; PADELETTI, Luigi ; SANTINI, Massimo ; CAPUCCI, Alessandro ; GULIZIA, Michele ; RICCI, Renato ; BIFFI, Mauro ; DE SANTO, Tiziana ; CORBUCCI, Giorgio</creator><creatorcontrib>BORIANI, Giuseppe ; LUCA BOTTO, Giovanni ; LIP, Gregory Y. H ; PADELETTI, Luigi ; SANTINI, Massimo ; CAPUCCI, Alessandro ; GULIZIA, Michele ; RICCI, Renato ; BIFFI, Mauro ; DE SANTO, Tiziana ; CORBUCCI, Giorgio ; Italian AT-500 Registry Investigators</creatorcontrib><description>In patients with atrial fibrillation (AF), stroke risk stratification schema do not consider AF parameters. The aim of the study is to assess the impact of combining risk factors with continuous AF burden monitoring.
In this retrospective study 568 patients implanted with a DDDR-P pacemaker (AT-500; Medtronic) and a history of AF were continuously monitored for 1 year.
During follow-up, 14 patients (2.5%) had a thromboembolic event. Patients were divided into 3 groups: AF burden ≤5 minutes per day (AF-free; n=223 [39%]), AF burden >5 minutes but <24 hours per day (AF-5 minutes; n=179 [32%]), and AF burden ≥24 hours (AF-24 hours; n=166 [29%]). Patients were also classified according to CHADS2 and CHA2DS2-VASc risk scores. The discrimination ability of each risk score was evaluated performing a logistic regression analysis and calculating the corresponding C-statistic. The addition of AF burden improved C-statistics: for CHADS2 from 0.653 (P=0.051) to 0.713 (P=0.007); for CHA2DS2-VASc, from 0.898 (P<0.0001) to 0.910 (P<0.0001).
The CHA2DS2-VASc score had a high sensitivity to predict thromboembolism. Implementation of device data on AF presence/duration/burden has the potential to contribute to improved clinical risk stratification and should be tested prospectively.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.110.609297</identifier><identifier>PMID: 21493904</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Arrhythmias, Cardiac - complications ; Arrhythmias, Cardiac - therapy ; Atrial Fibrillation - complications ; Biological and medical sciences ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Pacemaker, Artificial ; Retrospective Studies ; Risk Assessment - methods ; Risk Factors ; Sensitivity and Specificity ; Stroke - etiology ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2011-06, Vol.42 (6), p.1768-1770</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c206t-7021a29c0f242a8c60f315c1b58f5c44615a941183a8b1dce63609ddc3da557d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24253864$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21493904$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BORIANI, Giuseppe</creatorcontrib><creatorcontrib>LUCA BOTTO, Giovanni</creatorcontrib><creatorcontrib>LIP, Gregory Y. H</creatorcontrib><creatorcontrib>PADELETTI, Luigi</creatorcontrib><creatorcontrib>SANTINI, Massimo</creatorcontrib><creatorcontrib>CAPUCCI, Alessandro</creatorcontrib><creatorcontrib>GULIZIA, Michele</creatorcontrib><creatorcontrib>RICCI, Renato</creatorcontrib><creatorcontrib>BIFFI, Mauro</creatorcontrib><creatorcontrib>DE SANTO, Tiziana</creatorcontrib><creatorcontrib>CORBUCCI, Giorgio</creatorcontrib><creatorcontrib>Italian AT-500 Registry Investigators</creatorcontrib><title>Improving Stroke Risk Stratification Using the CHADS2 and CHA2DS2-VASc Risk Scores in Patients With Paroxysmal Atrial Fibrillation by Continuous Arrhythmia Burden Monitoring</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>In patients with atrial fibrillation (AF), stroke risk stratification schema do not consider AF parameters. The aim of the study is to assess the impact of combining risk factors with continuous AF burden monitoring.
In this retrospective study 568 patients implanted with a DDDR-P pacemaker (AT-500; Medtronic) and a history of AF were continuously monitored for 1 year.
During follow-up, 14 patients (2.5%) had a thromboembolic event. Patients were divided into 3 groups: AF burden ≤5 minutes per day (AF-free; n=223 [39%]), AF burden >5 minutes but <24 hours per day (AF-5 minutes; n=179 [32%]), and AF burden ≥24 hours (AF-24 hours; n=166 [29%]). Patients were also classified according to CHADS2 and CHA2DS2-VASc risk scores. The discrimination ability of each risk score was evaluated performing a logistic regression analysis and calculating the corresponding C-statistic. The addition of AF burden improved C-statistics: for CHADS2 from 0.653 (P=0.051) to 0.713 (P=0.007); for CHA2DS2-VASc, from 0.898 (P<0.0001) to 0.910 (P<0.0001).
The CHA2DS2-VASc score had a high sensitivity to predict thromboembolism. Implementation of device data on AF presence/duration/burden has the potential to contribute to improved clinical risk stratification and should be tested prospectively.</description><subject>Aged</subject><subject>Arrhythmias, Cardiac - complications</subject><subject>Arrhythmias, Cardiac - therapy</subject><subject>Atrial Fibrillation - complications</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Pacemaker, Artificial</subject><subject>Retrospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Stroke - etiology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkEtP4zAUhS00CMrjH4xG3oxYBfxM7WUojyJAIArMsnIcZ2pIbLAdRH8U_xFXFLG59xzpu1dHB4DfGB1iXOKj2f3dzeVpNa2yRYclkkSON8AIc8IKVhLxC4wQorIgTMptsBPjE0KIUMG3wDbBTFKJ2Ah8XPQvwb9Z9x_OUvDPBt7Z-LzSKtnW6jy9gw9xBaSFgZNpdTIjULlmJUnWxWM10-sr7YOJ0Dp4m--MSxH-s2mRXfDvy9irDlYp2LzObB1s1319r5dw4l2ybvBDhFUIi2Va9FbB4yE0xsFr72zyIUfYA5ut6qLZX-9d8HB2ej-ZFlc35xeT6qrQBJWpGCOCFZEatYQRJXSJWoq5xjUXLdeMlZgryTAWVIkaN9qUNPfXNJo2ivNxQ3fBwdff3M3rYGKa9zZqkwM7kzPOxVggiqVgmfyzJoe6N838JdheheX8u-EM_F0DKmrVtUE5beMPxwinomT0EwZ_jQY</recordid><startdate>201106</startdate><enddate>201106</enddate><creator>BORIANI, Giuseppe</creator><creator>LUCA BOTTO, Giovanni</creator><creator>LIP, Gregory Y. H</creator><creator>PADELETTI, Luigi</creator><creator>SANTINI, Massimo</creator><creator>CAPUCCI, Alessandro</creator><creator>GULIZIA, Michele</creator><creator>RICCI, Renato</creator><creator>BIFFI, Mauro</creator><creator>DE SANTO, Tiziana</creator><creator>CORBUCCI, Giorgio</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201106</creationdate><title>Improving Stroke Risk Stratification Using the CHADS2 and CHA2DS2-VASc Risk Scores in Patients With Paroxysmal Atrial Fibrillation by Continuous Arrhythmia Burden Monitoring</title><author>BORIANI, Giuseppe ; LUCA BOTTO, Giovanni ; LIP, Gregory Y. H ; PADELETTI, Luigi ; SANTINI, Massimo ; CAPUCCI, Alessandro ; GULIZIA, Michele ; RICCI, Renato ; BIFFI, Mauro ; DE SANTO, Tiziana ; CORBUCCI, Giorgio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c206t-7021a29c0f242a8c60f315c1b58f5c44615a941183a8b1dce63609ddc3da557d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Arrhythmias, Cardiac - complications</topic><topic>Arrhythmias, Cardiac - therapy</topic><topic>Atrial Fibrillation - complications</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Pacemaker, Artificial</topic><topic>Retrospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Stroke - etiology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BORIANI, Giuseppe</creatorcontrib><creatorcontrib>LUCA BOTTO, Giovanni</creatorcontrib><creatorcontrib>LIP, Gregory Y. H</creatorcontrib><creatorcontrib>PADELETTI, Luigi</creatorcontrib><creatorcontrib>SANTINI, Massimo</creatorcontrib><creatorcontrib>CAPUCCI, Alessandro</creatorcontrib><creatorcontrib>GULIZIA, Michele</creatorcontrib><creatorcontrib>RICCI, Renato</creatorcontrib><creatorcontrib>BIFFI, Mauro</creatorcontrib><creatorcontrib>DE SANTO, Tiziana</creatorcontrib><creatorcontrib>CORBUCCI, Giorgio</creatorcontrib><creatorcontrib>Italian AT-500 Registry Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BORIANI, Giuseppe</au><au>LUCA BOTTO, Giovanni</au><au>LIP, Gregory Y. H</au><au>PADELETTI, Luigi</au><au>SANTINI, Massimo</au><au>CAPUCCI, Alessandro</au><au>GULIZIA, Michele</au><au>RICCI, Renato</au><au>BIFFI, Mauro</au><au>DE SANTO, Tiziana</au><au>CORBUCCI, Giorgio</au><aucorp>Italian AT-500 Registry Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improving Stroke Risk Stratification Using the CHADS2 and CHA2DS2-VASc Risk Scores in Patients With Paroxysmal Atrial Fibrillation by Continuous Arrhythmia Burden Monitoring</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2011-06</date><risdate>2011</risdate><volume>42</volume><issue>6</issue><spage>1768</spage><epage>1770</epage><pages>1768-1770</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>In patients with atrial fibrillation (AF), stroke risk stratification schema do not consider AF parameters. The aim of the study is to assess the impact of combining risk factors with continuous AF burden monitoring.
In this retrospective study 568 patients implanted with a DDDR-P pacemaker (AT-500; Medtronic) and a history of AF were continuously monitored for 1 year.
During follow-up, 14 patients (2.5%) had a thromboembolic event. Patients were divided into 3 groups: AF burden ≤5 minutes per day (AF-free; n=223 [39%]), AF burden >5 minutes but <24 hours per day (AF-5 minutes; n=179 [32%]), and AF burden ≥24 hours (AF-24 hours; n=166 [29%]). Patients were also classified according to CHADS2 and CHA2DS2-VASc risk scores. The discrimination ability of each risk score was evaluated performing a logistic regression analysis and calculating the corresponding C-statistic. The addition of AF burden improved C-statistics: for CHADS2 from 0.653 (P=0.051) to 0.713 (P=0.007); for CHA2DS2-VASc, from 0.898 (P<0.0001) to 0.910 (P<0.0001).
The CHA2DS2-VASc score had a high sensitivity to predict thromboembolism. Implementation of device data on AF presence/duration/burden has the potential to contribute to improved clinical risk stratification and should be tested prospectively.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>21493904</pmid><doi>10.1161/STROKEAHA.110.609297</doi><tpages>3</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0039-2499 |
| ispartof | Stroke (1970), 2011-06, Vol.42 (6), p.1768-1770 |
| issn | 0039-2499 1524-4628 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_878031984 |
| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Ovid Autoload; Alma/SFX Local Collection |
| subjects | Aged Arrhythmias, Cardiac - complications Arrhythmias, Cardiac - therapy Atrial Fibrillation - complications Biological and medical sciences Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Pacemaker, Artificial Retrospective Studies Risk Assessment - methods Risk Factors Sensitivity and Specificity Stroke - etiology Vascular diseases and vascular malformations of the nervous system |
| title | Improving Stroke Risk Stratification Using the CHADS2 and CHA2DS2-VASc Risk Scores in Patients With Paroxysmal Atrial Fibrillation by Continuous Arrhythmia Burden Monitoring |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T03%3A45%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Improving%20Stroke%20Risk%20Stratification%20Using%20the%20CHADS2%20and%20CHA2DS2-VASc%20Risk%20Scores%20in%20Patients%20With%20Paroxysmal%20Atrial%20Fibrillation%20by%20Continuous%20Arrhythmia%20Burden%20Monitoring&rft.jtitle=Stroke%20(1970)&rft.au=BORIANI,%20Giuseppe&rft.aucorp=Italian%20AT-500%20Registry%20Investigators&rft.date=2011-06&rft.volume=42&rft.issue=6&rft.spage=1768&rft.epage=1770&rft.pages=1768-1770&rft.issn=0039-2499&rft.eissn=1524-4628&rft.coden=SJCCA7&rft_id=info:doi/10.1161/STROKEAHA.110.609297&rft_dat=%3Cproquest_pubme%3E878031984%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=878031984&rft_id=info:pmid/21493904&rfr_iscdi=true |