A comparison of CAS risk model and CHA<sub>2</sub>DS<sub>2</sub>-VASc risk model in guiding anticoagulation treatment in Chinese patients with non-valvular atrial fibrillation.

Jia Long Deng; Liu HE; Chao Jiang; Yi Wei Lai; De Yong Long; Cai Hua Sang; Chang Qi Jia; Li Feng; Xu LI; Man Ning; Rong HU; Jian Zeng Dong; Xin DU; Ri Bo Tang; Chang Sheng MA

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A comparison of CAS risk model and CHA₂DS₂-VASc risk model in guiding anticoagulation treatment in Chinese patients with non-valvular atrial fibrillation.

Author: Jia Long DENG ¹ ; Liu HE ¹ ; Chao JIANG ¹ ; Yi Wei LAI ¹ ; De Yong LONG ¹ ; Cai Hua SANG ¹ ; Chang Qi JIA ¹ ; Li FENG ¹ ; Xu LI ¹ ; Man NING ¹ ; Rong HU ¹ ; Jian Zeng DONG ¹ ; Xin DU ¹ ; Ri Bo TANG ¹ ; Chang Sheng MA ¹
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1. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Publication Type:Randomized Controlled Trial
MeSH: Adolescent; Anticoagulants; Atrial Fibrillation/drug therapy*; Cohort Studies; Female; Hemorrhage/complications*; Humans; Male; Retrospective Studies; Risk Assessment; Stroke/epidemiology*; Stroke Volume; Thromboembolism/etiology*; Ventricular Function, Left
From: Chinese Journal of Cardiology 2022;50(9):888-894
CountryChina
Language:Chinese
Abstract: Objective: To compare the differences between CAS risk model and CHA₂DS₂-VASc risk score in predicting all cause death, thromboembolic events, major bleeding events and composite endpoint in patients with nonvalvular atrial fibrillation. Methods: This is a retrospective cohort study. From the China Atrial Fibrillation Registry cohort study, the patients with atrial fibrillation who were>18 years old were randomly divided into CAS risk score group and CHA₂DS₂-VASc risk score group respectively. According to the anticoagulant status at baseline and follow-up, patients in the 2 groups who complied with the scoring specifications for anticoagulation were selected for inclusion in this study. Baseline information such as age and gender in the two groups were collected and compared. Follow-up was performed periodically to collect information on anticoagulant therapy and endpoints. The endpoints were all-cause death, thromboembolism events and major bleeding, the composite endpoint events were all-cause death and thromboembolism events. The incidence of endpoints in CAS group and CHA₂DS₂-VASc group was analyzed, and multivariate Cox proportional risk model was used to analyze whether the incidence of the endpoints was statistically different between the two groups. Results: A total of 5 206 patients with AF were enrolled, average aged (63.6±12.2) years, and 2092 (40.2%) women. There were 2 447 cases (47.0%) in CAS risk score group and 2 759 cases (53.0%) in CHA₂DS₂-VASc risk score group. In the clinical baseline data of the two groups, the proportion of left ventricular ejection fraction<55%, non-paroxysmal atrial fibrillation, oral warfarin and HAS BLED score in the CAS group were lower than those in the CHA₂DS₂-VASc group, while the proportion of previous diabetes history and history of antiplatelet drugs in the CAS group was higher than that in the CHA₂DS₂-VASc group, and there was no statistical difference in other baseline data. Patients were followed up for (82.8±40.8) months. In CAS risk score group, 225(9.2%) had all-cause death, 186 (7.6%) had thromboembolic events, 81(3.3%) had major bleeding, and 368 (15.0%) had composite endpoint. In CHA₂DS₂-VASc risk score group, 261(9.5%) had all-cause death 209(7.6%) had thromboembolic events, 112(4.1%) had major bleeding, and 424 (15.4%) had composite endpoint. There were no significant differences in the occurrence of all-cause death, thromboembolic events, major bleeding and composite endpoint between anticoagulation in CAS risk score group and anticoagulation in CHA₂DS₂-VASc risk score group (log-rank P =0.643, 0.904, 0.126, 0.599, respectively). Compared with CAS risk score, multivariable Cox proportional hazards regression models showed no significant differences for all-cause death, thromboembolic events, major bleeding and composite endpoint between the two groups with HR(95%CI) 0.95(0.80-1.14), 1.00(0.82-1.22), 0.83(0.62-1.10), 0.96(0.84-1.11), respectively. All P>0.05. Conclusions: There were no significant differences between CAS risk model and CHA₂DS₂-VASc risk score in predicting all-cause death, thromboembolic events, and major bleeding events in Chinese patients with non-valvular atrial fibrillation.

A comparison of CAS risk model and CHA2DS2-VASc risk model in guiding anticoagulation treatment in Chinese patients with non-valvular atrial fibrillation.

A comparison of CAS risk model and CHA₂DS₂-VASc risk model in guiding anticoagulation treatment in Chinese patients with non-valvular atrial fibrillation.