Relationship Between CHADS2 Score and Efficacy of Antiarrhythmic Drug Therapy in Patients With Paroxysmal Atrial Fibrillation

Takashi Komatsu, Yoshihiro Sato, Mahito Ozawa, Fusanori Kunugita, Hironobu Ueda, Hideaki Tachibana, Yoshihiro Morino, Motoyuki Nakamura
2013 Circulation Journal  
The Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled] (CHADS2) score is a useful scheme for risk stratification of thromboembolism patients, but there is little information about its usefulness for the evaluation of antiarrhythmic drug (AAD) therapy. Methods and Results: This study included 459 paroxysmal atrial fibrillation (AF) patients (309 men, mean age 66±12 years, mean follow-up 50±35 months) and prophylactic efficacy was analyzed on the basis of CHADS2 score. (1) Survival
more » ... es free from AF recurrence at 1, 6, 12 and 24 months were, respectively, 89%, 74%, 63% and 47% in score-0 group (n=152); 92%, 68%, 59% and 48% in score-1 group (n=158); 86%, 64%, 56% and 46% in score-2 group (n=84); 81%, 65%, 51% and 35% in score-3 group (n=43); and 68%, 50%, 36% and 18% in ≥score-4 group (n=22) (P<0.05; score-0, score-1 or score-2 vs. ≥score-4 group). (2) Survival rates free from progression to chronic AF at 12, 36, 60 and 90 months were, respectively, 95%, 93%, 91% and 89% in score-0 group; 97%, 91%, 89% and 88% in score-1 group; 96%, 93%, 88% and 83% in score-2 group; 91%, 74%, 67% and 60% in score-3 group; and 91%, 82%, 68% and 55% in ≥score-4 group (P<0.01; score-0, score-1 or score-2 vs. ≥score-4 group). (3) In multivariate logistic regression analysis adjusted for potentially confounding variables, CHADS2 score was associated with AF recurrence (odds ratio [OR] 1.45, 95% confidence interval [CI] 1.16-1.81, P<0.001), and progression to chronic AF during AAD therapy (OR 1.64, 95% CI 1.04-2.69, P<0.001). Conclusions: When using a rhythm control strategy, the CHADS2 score is a useful scheme for predicting the outcome of AAD treatment of patients with paroxysmal AF. (Circ J 2013; 77: 639 -645)
doi:10.1253/circj.cj-12-0854 pmid:23220771 fatcat:bkewkue73zgm3hqh7hjbofwtrq