- 著者
- Daniele Pastori José Miguel Rivera-Caravaca María Asunción Esteve-Pastor Vanessa Roldán Francisco Marín Pasquale Pignatelli Francesco Violi Gregory Y.H. Lip
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-17-1318, (Released:2018-03-16)
- 参考文献数
- 32
- 被引用文献数
- 3
Background:Two risk scores have been developed to predict composite outcomes in atrial fibrillation (AF): the 2MACE and TIMI-AF scores. The aim of this study was to compare the predictive ability of these scores in 2 separate warfarin-treated cohorts (one ‘real world’, one clinical trial) of AF patients.Methods and Results:The 2MACE and TIMI-AF scores were calculated in the ‘real-world’ ATHERO-AF cohort (n=907), and in the randomized controlled AMADEUS trial (n=2,265). Endpoints were major adverse cardiovascular events (MACEs), net clinical outcomes (NCO) and a combination of them, namely “clinically relevant events” (CREs). ROC curves showed similar predictive ability for MACE for 2MACE and TIMI-AF, in both the ATHERO-AF (0.698 vs. 0.688, respectively P=0.783) and AMADEUS (0.657 vs. 0.569, respectively P=0.057) cohorts. Similarly, the TIMI-AF showed a comparable c-index with 2MACE for NCOs in the ATHERO-AF (0.676 vs. 0.667, P=0.737), and AMADEUS (0.666 vs. 0.663, P=0.859) cohorts. No differences were found between the 2 scores for the prediction of CREs (0.675 vs. 0.684, P=0.740 in ATHERO-AF and 0.669 vs. 0.667, P=0.889 in AMADEUS for 2MACE and TIMI-AF, respectively).Conclusions:This study showed that the 2MACE and TIMI-AF scores had modest but significant predictive ability for composite outcomes in AF. The clinical usefulness of both scores was similar, but the 2MACE score may be simpler and easy to use.
- 著者
- María Asunción Esteve-Pastor Amaya García-Fernández Manuel Macías Francisco Sogorb Mariano Valdés Vanessa Roldán Javier Muñiz Lina Badimon Inmaculada Roldán Vicente Bertomeu-Martínez Ángel Cequier Gregory Y.H. Lip Manuel Anguita Francisco Marín on behalf of FANTASIIA Investigators
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.80, no.10, pp.2102-2108, 2016-09-23 (Released:2016-09-23)
- 参考文献数
- 39
- 被引用文献数
- 6 19
Background:Several bleeding risk scores have been validated in patients with atrial fibrillation (AF). The ORBIT score has been recently proposed as a simple score with the best ability to predict major bleeding. The present study aimed to test the hypothesis that the ORBIT score was superior to the HAS-BLED score for predicting major bleeding and death in “real world” anticoagulated AF patients.Methods and Results:We analyzed the predictive performance for bleeding and death of 406 AF patients who underwent 571 electrical cardioversion procedures and 1,276 patients with permanent/persistent AF from the FANTASIIA registry. In the cardioversion population, 21 patients had major bleeding events and 26 patients died. The predictive performance for major bleeding of HAS-BLED and ORBIT were not significantly different (c-statistics 0.77 (95% CI 0.66–0.88) and 0.82 (95% CI 0.77–0.93), respectively; P=0.080). For the FANTASIIA population, 46 patients had major bleeding events and 50 patients died. The predictive performances for major bleeding of HAS-BLED and ORBIT were not significantly different (c-statistics 0.63 (95% CI 0.56–0.71) and 0.70 (95% CI 0.62–0.77), respectively; P=0.116). For death, the predictive performances of HAS-BLED and ORBIT were not significantly different in both populations. The ORBIT score categorized most patients as “low risk”.Conclusions:Despite the original claims in its derivation paper, the ORBIT score was not superior to HAS-BLED for predicting major bleeding and death in a “real world” oral anticoagulated AF population. (Circ J 2016; 80: 2102–2108)