Predictors of Progression and Prognosis of Paroxysmal Atrial Fibrillation.
10.3904/kjm.2015.88.6.672
- Author:
Ji Eun KIM
1
;
Ki Hong LEE
;
Seunghun LEE
;
Hyukjin PARK
;
Hyun Kuk KIM
;
Sung Soo KIM
;
Hae Chang JEONG
;
Jae Yeong CHO
;
Keun Ho PARK
;
Doo Sun SIM
;
Hyun Joo YOON
;
Nam Sik YOON
;
Hyung Wook PARK
;
Kye Hun KIM
;
Young Joon HONG
;
Ju Han KIM
;
Youngkeun AHN
;
Myung Ho JEONG
;
Jeong Gwan CHO
;
Jong Chun PARK
Author Information
1. Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. mdhwp@chol.com
- Publication Type:Original Article
- Keywords:
Atrial fibrillation;
Paroxysmal;
Progression;
Prognosis
- MeSH:
Atrial Fibrillation*;
Electric Countershock;
Follow-Up Studies;
Heart Failure;
Hospitalization;
Humans;
Korea;
Prognosis*;
Stroke
- From:Korean Journal of Medicine
2015;88(6):672-679
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Significant numbers of patients with paroxysmal atrial fibrillation (AF) proceed to persistent AF and have poor clinical outcomes despite the use of antiarrhythmic agents or direct-current cardioversion. We compared the CHADS2, CHA2DS2-VASc, and HATCH scoring systems to predict AF progression and prognosis and identify the most useful scoring system in Korea. METHODS: A total of 559 consecutive patients with paroxysmal symptomatic AF were analyzed. The progression of AF and clinical outcomes were determined after at least 1 year of follow-up. Clinical outcomes were defined as the composite of death, hospitalization due to heart failure, and new-onset stroke. Each score was calculated, and its predictive accuracy for AF progression and prognosis was compared. RESULTS: A total of 147 patients with paroxysmal AF (26.3%) proceeded to persistent AF. The HATCH score (area under the curve [AUC], 0.601; p < 0.001) was the most powerful scoring system for the prediction of AF progression, although the CHADS2 (AUC, 0.565) and CHA2DS2-VASc (AUC, 0.558) were also useful. The CHA2DS2-VASc (AUC, 0.734; p < 0.001) was the most powerful scoring system for the prediction of clinical outcomes with a more significant linear correlation (0: 3.3% vs. 1: 6.3% vs. 2: 15.4% vs. 3: 20.7% vs. 4: 18.0% vs. 5: 53.6% vs. > or = 6: 55.6%, linear p < 0.001) than the CHADS2 (AUC, 0.720) and HATCH scoring systems (AUC, 0.723). CONCLUSIONS: Although the CHADS2, CHA2DS2-VASc, and HATCH scoring systems were useful predictors of progression from paroxysmal to persistent AF, the CHA2DS2-VASc score was the most useful and accurate for the prediction of clinical outcomes.
