Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 143-149 |
| Number of pages | 7 |
| Journal | International Journal of Cardiology |
| Volume | 231 |
| DOIs | |
| Publication status | Published - 2017 |
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Keywords
- adult
- age
- Article
- atrial fibrillation
- cardiovascular disease
- cardiovascular disease assessment
- cardiovascular risk
- carotid atherosclerosis
- cerebrovascular accident
- CHA2DS2 VASc score
- comorbidity
- controlled study
- disease association
- event free survival
- female
- follow up
- gender
- human
- Italian (citizen)
- major clinical study
- male
- medical history
- middle aged
- observational study
- post hoc analysis
- predictive value
- prevalence
- retrospective study
- risk assessment
- risk factor
- survival analysis
- transient ischemic attack
- aged
- ankle brachial index
- atherosclerotic plaque
- carotid artery disease
- clinical trial
- complication
- Doppler ultrasonography
- incidence
- Italy
- multicenter study
- procedures
- survival rate
- trends
- very elderly, Aged
- Aged, 80 and over
- Ankle Brachial Index
- Atrial Fibrillation
- Carotid Artery Diseases
- Female
- Humans
- Incidence
- Male
- Plaque, Atherosclerotic
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Survival Rate
- Ultrasonography, Doppler
Cite this
Carotid plaque detection improves the predictive value of CHA2DS2-VASc score in patients with non-valvular atrial fibrillation: The ARAPACIS Study. / ARAPACIS Study Investigators ; Moia, Marco.
In: International Journal of Cardiology, Vol. 231, 2017, p. 143-149.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Carotid plaque detection improves the predictive value of CHA2DS2-VASc score in patients with non-valvular atrial fibrillation: The ARAPACIS Study
AU - Basili, S.
AU - Loffredo, L.
AU - Pastori, D.
AU - Proietti, M.
AU - Farcomeni, A.
AU - Vestri, A.R.
AU - Pignatelli, P.
AU - Davì, G.
AU - Hiatt, W.R.
AU - Lip, G.Y.H.
AU - Corazza, G.R.
AU - Perticone, F.
AU - Violi, F.
AU - ARAPACIS Study Investigators
AU - Moia, Marco
PY - 2017
Y1 - 2017
N2 - Background and aims Vascular disease (VD), as assessed by history of myocardial infarction or peripheral artery disease or aortic plaque, increases stroke risk in atrial fibrillation (AF), and is a component of risk assessment using the CHA2DS2-VASc score. We investigated if systemic atherosclerosis as detected by ultrasound carotid plaque (CP) could improve the predictive value of the CHA2DS2-VASc score. Methods We analysed data from the ARAPACIS study, an observational study including 2027 Italian patients with non-valvular AF, in whom CP was detected using Doppler Ultrasonography. Results VD was reported in 351 (17.3%) patients while CP was detected in 16.6% patients. Adding CP to the VD definition leaded to higher VD prevalence (30.9%). During a median [IQR] follow-up time of 36 months, 56 (2.8%) stroke/TIA events were recorded. Survival analysis showed that conventional VD alone did not increase the risk of stroke (Log-Rank: 0.009, p = 0.924), while addition of CP to conventional VD was significantly associated to an increased risk of stroke (LR: 5.730, p = 0.017). Cox regression analysis showed that VD + CP was independently associated with stroke (HR: 1.78, 95% CI: 1.05–3.01, p = 0.0318). Reclassification analysis showed that VD + CP allowed a significant risk reclassification when compared to VD alone in predicting stroke at 36 months (NRI: 0.192, 95% CI: 0.028–0.323, p = 0.032). Conclusions In non-valvular AF patients the addition of ultrasound detection of carotid plaque to conventional VD significantly increases the predictive value of CHA2DS2-VASc score for stroke. © 2017
AB - Background and aims Vascular disease (VD), as assessed by history of myocardial infarction or peripheral artery disease or aortic plaque, increases stroke risk in atrial fibrillation (AF), and is a component of risk assessment using the CHA2DS2-VASc score. We investigated if systemic atherosclerosis as detected by ultrasound carotid plaque (CP) could improve the predictive value of the CHA2DS2-VASc score. Methods We analysed data from the ARAPACIS study, an observational study including 2027 Italian patients with non-valvular AF, in whom CP was detected using Doppler Ultrasonography. Results VD was reported in 351 (17.3%) patients while CP was detected in 16.6% patients. Adding CP to the VD definition leaded to higher VD prevalence (30.9%). During a median [IQR] follow-up time of 36 months, 56 (2.8%) stroke/TIA events were recorded. Survival analysis showed that conventional VD alone did not increase the risk of stroke (Log-Rank: 0.009, p = 0.924), while addition of CP to conventional VD was significantly associated to an increased risk of stroke (LR: 5.730, p = 0.017). Cox regression analysis showed that VD + CP was independently associated with stroke (HR: 1.78, 95% CI: 1.05–3.01, p = 0.0318). Reclassification analysis showed that VD + CP allowed a significant risk reclassification when compared to VD alone in predicting stroke at 36 months (NRI: 0.192, 95% CI: 0.028–0.323, p = 0.032). Conclusions In non-valvular AF patients the addition of ultrasound detection of carotid plaque to conventional VD significantly increases the predictive value of CHA2DS2-VASc score for stroke. © 2017
KW - adult
KW - age
KW - Article
KW - atrial fibrillation
KW - cardiovascular disease
KW - cardiovascular disease assessment
KW - cardiovascular risk
KW - carotid atherosclerosis
KW - cerebrovascular accident
KW - CHA2DS2 VASc score
KW - comorbidity
KW - controlled study
KW - disease association
KW - event free survival
KW - female
KW - follow up
KW - gender
KW - human
KW - Italian (citizen)
KW - major clinical study
KW - male
KW - medical history
KW - middle aged
KW - observational study
KW - post hoc analysis
KW - predictive value
KW - prevalence
KW - retrospective study
KW - risk assessment
KW - risk factor
KW - survival analysis
KW - transient ischemic attack
KW - aged
KW - ankle brachial index
KW - atherosclerotic plaque
KW - carotid artery disease
KW - clinical trial
KW - complication
KW - Doppler ultrasonography
KW - incidence
KW - Italy
KW - multicenter study
KW - procedures
KW - survival rate
KW - trends
KW - very elderly, Aged
KW - Aged, 80 and over
KW - Ankle Brachial Index
KW - Atrial Fibrillation
KW - Carotid Artery Diseases
KW - Female
KW - Humans
KW - Incidence
KW - Male
KW - Plaque, Atherosclerotic
KW - Retrospective Studies
KW - Risk Assessment
KW - Risk Factors
KW - Survival Rate
KW - Ultrasonography, Doppler
U2 - 10.1016/j.ijcard.2017.01.001
DO - 10.1016/j.ijcard.2017.01.001
M3 - Article
VL - 231
SP - 143
EP - 149
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -