The thromboembolism risk of low-risk atrial fibrillation patients with different clinical characteristics.
10.3760/cma.j.cn112148-20200306-00164
- Author:
Xiao Bo LIU
1
;
Zhao Xu JIA
1
;
Shi Jun XIA
1
;
Liu HE
1
;
Shang Xin LU
1
;
Xue Yuan GUO
1
;
Song Nan LI
1
;
Nian LIU
1
;
Chen Xi JIANG
1
;
Cai Hua SANG
1
;
Ri Bo TANG
1
;
De Yong LONG
1
;
Rong Hui YU
1
;
Rong BAI
1
;
Jia Hui WU
1
;
Xin DU
1
;
Jian Zeng DONG
1
;
Chang Sheng MA
1
Author Information
1. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing 100029, China.
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
CHA(2)DS(2)-VASc score;
Thromboembolism
- MeSH:
Adult;
Aged;
Anticoagulants;
Atrial Fibrillation;
China;
Female;
Humans;
Male;
Middle Aged;
Risk Assessment;
Risk Factors;
Stroke;
Thromboembolism
- From:
Chinese Journal of Cardiology
2020;48(9):735-739
- CountryChina
- Language:Chinese
-
Abstract:
Objective: This study explored the thromboembolism risk of low-risk atrial fibrillation (AF) patients (CHA2DS2-VASc score of 0 or 1 for male and 1 or 2 for female) with different clinical characteristics to provide the basis for anticoagulation decision-making in these patients. Methods: We prospectively enrolled consecutive 2 862 nonvalvular low-risk AF patients between August 2011 to December 2018 in China-AF (China Atrial Fibrillation Registry) Study, their CHA2DS2-VASc score was 0 or 1 for male and 1 or 2 for female. According to their age, sex, presence or absence of hypertension, diabetes mellitus, congestive heart failure, and vascular disease at the time of enrolling, patients were divided into CHA2DS2-VASc score 0 score group, 1 score group, and 2 score group. Patients were followed up every 6 months by outpatient clinic visit or telephone interview. The outcome was a thromboembolic event, including ischemic stroke and systemic embolism. Univariate Cox regression analysis was used to compare the thromboembolism risk between the patients with different risk factors and CHA2DS2-VASc score 0 group. Results: A total of 2 862 low-risk atrial fibrillation patients were enrolled in this study. 915 patients (32.0%) were female, and age was (55.0±10.7) years old. There were 933 patients (32.6%) in CHA2DS2-VASc score 0 group, 1 401 patients (49.0%) in score 1 group and 528 patients (18.5%) in score 2 group. During follow-up (median 1.5 years, 5 811.82 person-years), 33 cases of thromboembolic events were recorded, the annual rate of thromboembolism was 0.57% (95%CI 0.40%~0.80%). The number of thromboembolic events in patients with CHA2DS2-VASc score 0, 1 and 2 were 8, 11 and 14, respectively, and the annual thromboembolism event rates were 0.40% (95%CI 0.20%-0.81%), 0.39% (95%CI 0.22%-0.71%) and 1.34% (95%CI 0.80%-2.27%), respectively. The risk of thromboembolism of CHA2DS2-VASc score 2 group (HR=3.53, 95%CI 1.48-8.44; P=0.005), especially female patients aged 65-74 years in CHA2DS2-VASc score 2 group (HR=2.67, 95%CI 1.63-4.38; P<0.000) was significantly higher than that in patients of CHA2DS2-VASc score 0 group. Conclusion: Low-Risk Atrial Fibrillation patients with CHA2DS2-VASc score 2, especially female patients aged 65-74 years old with CHA2DS2-VASc score 2 are at higher risk of thromboembolism in low-risk AF patients. For such patients, intensified oral anticoagulant therapy might be helpful to reduce the risk of thrombolism.
