title: Clinical utility of CHADS2 and CHA2DS2-VASc scoring systems for predicting postoperative atrial fibrillation after cardiac surgery.
abstract: OBJECTIVE
  The presence of postoperative atrial fibrillation predicts a higher short- and long-term mortality rates; however, no scoring system has been used to discriminate patients at high risk for this complication. The aim of this study was to investigate whether the CHADS2 and CHA2DS2-VASc scores are useful risk assessment tools for new-onset atrial fibrillation after cardiac surgery.
  
  
  METHODS
  A total of 277 consecutive patients who underwent cardiac surgery were prospectively included in this risk stratification study. We calculated the CHADS2 and CHA2DS2-VASc scores from the data collected. The primary end point was the development of postoperative atrial fibrillation within 30 days after cardiac surgery.
  
  
  RESULTS
  Eighty-four (30%) of the patients had postoperative atrial fibrillation at a median of 2 days (range, 0-27 days) after cardiac surgery. The CHADS2 and CHA2DS2-VASc scores were significant predictors of postoperative atrial fibrillation in separate multivariate regression analyses. The Kaplan-Meier analysis obtained a higher postoperative atrial fibrillation rate when based on the CHADS2 and CHA2DS2-VASc scores of at least 2 than when based on scores less than 2 (both log rank, P < .001). In addition, the CHA2DS2-VASc scores could be used to further stratify the patients with CHADS2 scores of 0 or 1 into 2 groups with different postoperative atrial fibrillation rates at a cutoff value of 2 (12% vs 32%; P = .01).
  
  
  CONCLUSIONS
  CHADS2 and CHA2DS2-VASc scores were predictive of postoperative atrial fibrillation after cardiac surgery and may be helpful for identifying high-risk patients.
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Department of General Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
authors.forename: Su-Kiat
authors.initials: SK
authors.lastname: Chua
authors.forename: Kou-Gi
authors.initials: KG
authors.lastname: Shyu
authors.forename: Ming-Jen
authors.initials: MJ
authors.lastname: Lu
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Lien
authors.forename: Chia-Hsun
authors.initials: CH
authors.lastname: Lin
authors.forename: Hung-Hsing
authors.initials: HH
authors.lastname: Chao
authors.forename: Huey-Ming
authors.initials: HM
authors.lastname: Lo
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016009:Chi-Square Distribution; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D018579:Patient Selection; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: 23.1; 24; AF; CABG; CI; E; LV; LVEDD; LVM; OR; PAD; POAF; PWTD; SWTD; TIA; atrial fibrillation; confidence interval; coronary artery bypass grafting; early mitral inflow velocity; e′; interventricular septal wall thickness; left ventricular; left ventricular end-diastolic diameter; left ventricular mass; medial mitral annular velocity during passive filling; odds ratio; peripheral arterial disease; posterior wall thickness; postoperative atrial fibrillation; transient ischemic attack