Renal dysfunction and the risk of thromboembolic events in patients with atrial fibrillation after catheter ablation--the potential role beyond the CHA2DS2-VASc score.
Heart Rhythm
; 9(11): 1755-60, 2012 Nov.
Article
em En
| MEDLINE
| ID: mdl-22760084
ABSTRACT
BACKGROUND:
Renal dysfunction is recognized as an important risk factor for thromboembolic (TE) events in patients with atrial fibrillation (AF) under medical treatment.OBJECTIVE:
To investigate whether renal dysfunction is a useful predictor of TE events among patients receiving AF ablation. We also aimed to determine whether the diagnostic accuracy of the CHA(2)DS(2)-VASc score in predicting TE events could be improved by adding renal dysfunction into the scoring system.METHODS:
We enrolled a total of 547 patients with AF who underwent catheter ablation. Renal dysfunction was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m(2). The clinical end point was the occurrence of TE events (ischemic stroke, transient ischemic attack, or other systemic embolisms) during follow-up after catheter ablation.RESULTS:
During a follow-up of 38.9 ± 22.5 months, 16 patients (2.9%) experienced TE events. Both the CHA(2)DS(2)-VASc score and renal dysfunction were independent predictors of TE events in the multivariate analysis. Among patients with a CHA(2)DS(2)-VASc score of 0 or 1, renal dysfunction can further stratify them into 2 groups with different event rates (4.3% vs 0.3%; P = .046). A new scoring system derived by assigning 1 more point representing renal dysfunction to the CHA(2)DS(2)-VASc score could improve its predictive accuracy; the area under the receiver operating characteristic curve increased from 0.84 to 0.88 (P = .043).CONCLUSIONS:
Renal dysfunction was a significant risk factor for TE events after catheter ablation of AF and may improve the diagnostic accuracy of the CHA(2)DS(2)-VASc score.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Tromboembolia
/
Ablação por Cateter
/
Insuficiência Renal
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article