| Title: |
Carotid plaque detection improves the predictive value of CHA2DS2-VASc score in patients with non-valvular atrial fibrillation: The ARAPACIS Study |
| Authors: |
Basili, Stefania; Loffredo, Lorenzo; Pastori, Daniele; Proietti, Marco; Farcomeni, Alessio; Vestri, Anna Rita; Pignatelli, Pasquale; Davì, Giovanni; Hiatt, William R.; Lip, Gregory Y. H.; Corazza, Gino R.; Perticone, Francesco; Violi, Francesco; in collaboration with ARAPACIS Study Investigators; Puato, Massimo |
| Contributors: |
Basili, Stefania; Loffredo, Lorenzo; Pastori, Daniele; Proietti, Marco; Farcomeni, Alessio; Vestri, Anna Rita; Pignatelli, Pasquale; Davì, Giovanni; Hiatt, William R.; Lip, Gregory Y. H.; Corazza, Gino R.; Perticone, Francesco; Violi, Francesco; In Collaboration With Arapacis Study Investigators; Puato, Massimo |
| Publication Year: |
2017 |
| Collection: |
Università degli studi di Trieste: ArTS (Archivio della ricerca di Trieste) |
| Subject Terms: |
Atherosclerosi; Atrial fibrillation; Carotid plaque; CHA; DS; VASc score; Stroke; Vascular disease |
| Time: |
2 |
| Description: |
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 Ialian patents 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% patents. 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 pedictive value of CHA2DS2-VASc score for stroke. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
volume:231; firstpage:143; lastpage:149; numberofpages:7; journal:INTERNATIONAL JOURNAL OF CARDIOLOGY; https://hdl.handle.net/11368/3119854 |
| DOI: |
10.1016/j.ijcard.2017.01.001 |
| Availability: |
https://hdl.handle.net/11368/3119854; https://doi.org/10.1016/j.ijcard.2017.01.001 |
| Accession Number: |
edsbas.806584F1 |
| Database: |
BASE |