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Clinical utility an...
Clinical utility and prognostic implications of the novel 4S-AF scheme to characterize and evaluate patients with atrial fibrillation : a report from ESC-EHRA EORP-AF Long-Term General Registry
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- Ding, Wern Yew (författare)
- Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England.;Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England.
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- Proietti, Marco (författare)
- Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England.;Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England.;Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy.;IRCCS Ist Clin Scientif Maugeri, Geriatr Unit, Milan, Italy.
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- Boriani, Giuseppe (författare)
- Univ Modena & Reggio Emilia, Dept Biomed Metab & Neural Sci, Cardiol Div, Policlin Modena, Modena, Italy.
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- Fauchier, Laurent (författare)
- Ctr Hosp Univ Trousseau, Serv Cardiol, Tours, France.
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- Blomström-Lundqvist, Carina (författare)
- Uppsala universitet,Kardiologi
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- Marin, Francisco (författare)
- Univ Murcia, Hosp Univ Virgen Arrixaca, Dept Cardiol, CIBERCV, Murcia, Spain.
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- Potpara, Tatjana S. (författare)
- Univ Belgrade, Sch Med, Belgrade, Serbia.;Clin Ctr Serbia, Cardiol Clin, Intens Arrhythmia Care, Belgrade, Serbia.
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- Lip, Gregory Y. H. (författare)
- Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England.;Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England.;Aalborg Univ, Dept Clin Med, Aalborg Thrombosis Res Unit, Aalborg, Denmark.
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Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England;Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England. Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England.;Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England.;Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy.;IRCCS Ist Clin Scientif Maugeri, Geriatr Unit, Milan, Italy. (creator_code:org_t)
- 2021-11-22
- 2022
- Engelska.
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 24:5, s. 721-728
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Aims: The 4S-AF classification scheme comprises of four domains: stroke risk (St), symptoms (Sy), severity of atrial fibrillation (AF) burden (Sb), and substrate (Su). We sought to examine the implementation of the 4S-AF scheme in the EORP-AF General Long-Term Registry and compare outcomes in AF patients according to the 4S-AF-led decision-making process.Methods and results: Atrial fibrillation patients from 250 centres across 27 European countries were included. A 4S-AF score was calculated as the sum of each domain with a maximum score of 9. Of 6321 patients, 8.4% had low (St), 47.5% EHRA I (Sy), 40.5% newly diagnosed or paroxysmal AF (Sb), and 5.1% no cardiovascular risk factors or left atrial enlargement (Su). Median follow-up was 24 months. Using multivariable Cox regression analysis, independent predictors of all-cause mortality were (St) [adjusted hazard ratio (aHR) 8.21, 95% confidence interval (CI): 2.60-25.9], (Sb) (aHR 1.21, 95% CI: 1.08-1.35), and (Su) (aHR 1.27, 95% CI: 1.14-1.41). For CV mortality and any thromboembolic event, only (Su) (aHR 1.73, 95% CI: 1.45-2.06) and (Sy) (aHR 1.29, 95% CI: 1.00-1.66) were statistically significant, respectively. None of the domains were independently linked to ischaemic stroke or major bleeding. Higher 4S-AF score was related to a significant increase in all-cause mortality, CV mortality, any thromboembolic event, and ischaemic stroke but not major bleeding. Treatment of all 4S-AF domains was associated with an independent decrease in all-cause mortality (aHR 0.71, 95% CI: 0.55-0.92). For each 4S-AF domain left untreated, the risk of all-cause mortality increased substantially (aHR 1.35, 95% CI: 1.16-1.56).Conclusion: Implementation of the novel 4S-AF scheme is feasible, and treatment decisions based on this scheme improve mortality rates in AF.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Atrial fibrillation
- 4S-AF
- Characterization
- Classification
- EORP-AF registry
- Validation
- Prognostic implications
- Mortality
- Thromboembolism
- Stroke
- Bleeding
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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