著者

Takahiro Yamauchi Yasuo Okumura Koichi Nagashima Ryuta Watanabe Yuki Saito Katsuaki Yokoyama Naoya Matsumoto Katsumi Miyauchi Sakiko Miyazaki Hidemori Hayashi Yuya Matsue Yuji Nishizaki Shuko Nojiri Tohru Minamino Hiroyuki Daida

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0318, (Released:2023-08-09)

参考文献数

30

被引用文献数

2

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Background: The HELT-E2S2score, which assigns 1 point to Hypertension, Elderly aged 75–84 years, Low body mass index <18.5 kg/m2, and Type of atrial fibrillation (AF: persistent/permanent), and 2 points to Extreme Elderly aged ≥85 years and previous Stroke, has been proposed as a new risk stratification for strokes in Japanese AF patients, but has not yet undergone external validation.Methods and Results: We evaluated the prognostic performance of the HELT-E2S2score for stroke risk stratification using 2 large-scale registries in Japanese AF patients (n=7,020). During 23,241 person-years of follow-up (mean follow-up 1,208±450 days), 287 ischemic stroke events occurred. The C-statistic using the HELT-E2S2score was 0.661 (95% confidence interval [CI], 0.629–0.692), which was numerically higher than with the CHADS2score (0.644, 95% CI 0.613–0.675; P=0.15 vs. HELT-E2S2) or CHA2DS2-VASc score (0.650, 95% CI, 0.619–0.680; P=0.37 vs. HELT-E2S2). In the SAKURA AF Registry, the C-statistic of the HELT-E2S2score was consistently higher than the CHADS2and CHA2DS2-VASc scores across all 3 types of facilities comprising university hospitals, general hospitals, and clinics. However, in the RAFFINE Study, its superiority was only observed in general hospitals.Conclusions: The HELT-E2S2score demonstrated potential value for risk stratification, particularly in a super-aged society such as Japan. However, its superiority over the CHADS2or CHA2DS2-VASc scores may vary across different hospital settings.