AUTHOR=Wu Yangxun , Wang Guanyun , Dong Lisha , Qin Liu'an , Li Jian , Yan Hengming , Guo Wenjie , Feng Xiaodong , Zou Yuting , Wang Ziqian , Du Rina , Zhang Yuxiao , Ma Jing , Yin Tong 

TITLE=Assessment of the CHA2DS2-VASc Score for the Prediction of Death in Elderly Patients With Coronary Artery Disease and Atrial Fibrillation

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.805234

DOI=10.3389/fcvm.2021.805234

ISSN=2297-055X

ABSTRACT=<p><bold>Purpose:</bold> Coronary artery disease (CAD) and atrial fibrillation (AF) often coexist and lead to a much higher risk of mortality in the elderly population. The aim of this study was to investigate whether the CHA<sub>2</sub>DS<sub>2</sub>-VASc score could predict the risk of death in elderly patients with CAD and AF.</p><p><bold>Methods:</bold> Hospitalized patients aged ≥65 years with a diagnosis of CAD and AF were recruited consecutively. Patients were divided into 5 groups according to the CHA<sub>2</sub>DS<sub>2</sub>-VASc score (≤2, =3, =4, =5, and ≥6). At least a 1-year follow-up was carried out for the assessment of all-cause death.</p><p><bold>Results:</bold> A total of 1,579 eligible patients were recruited, with 582 all-cause deaths (6.86 per 100 patient-years) occurring during a follow-up of at least 1 year. With the increase in the CHA<sub>2</sub>DS<sub>2</sub>-VASc score, the 1-year and 5-year survival rate decreased (96.4% vs. 95.7% vs. 94.0% vs. 86.5% vs. 85.7%, respectively, <italic>P</italic> &lt; 0.001; 78.4% vs. 68.9% vs. 64.6% vs. 55.5% vs. 50.0%, respectively, <italic>P</italic> &lt; 0.001). Compared with the patients with CHA<sub>2</sub>DS<sub>2</sub>-VASc score &lt;5, for patients with CHA<sub>2</sub>DS<sub>2</sub>-VASc score ≥5, the adjusted hazard ratio for death was 1.78 (95% CI: 1.45–2.18, <italic>P</italic> &lt; 0.001). The predictive values of the CHA<sub>2</sub>DS<sub>2</sub>-VASc score ≥5 for in-hospital (C-index = 0.66, 95% CI: 0.62–0.69, <italic>P</italic> &lt; 0.001), 1-year (C-index = 0.65, 95% CI: 0.63–0.67, <italic>P</italic> &lt; 0.001) and 5-year (C-index = 0.60, 95% CI: 0.59–0.61, <italic>P</italic> &lt; 0.001) death were in comparable.</p><p><bold>Conclusion:</bold> In elderly patients with concomitant CAD and AF, the CHA<sub>2</sub>DS<sub>2</sub>-VASc score can be used to predict death with moderate accuracy.</p>