title: Use of preoperative CHA2 DS2 -VASc score to predict the risk of atrial fibrillation after cardiothoracic surgery: a nested case-control study from the Atrial Fibrillation Suppression Trials (AFIST) I, II, and III.
abstract: OBJECTIVE
  To evaluate whether the preoperative CHA2 DS2 -VASc score predicts the risk of atrial fibrillation (AF) after cardiothoracic surgery (CTS).
  
  
  METHODS
  Retrospective, nested case-control study.
  
  
  METHODS
  A total of 560 patients undergoing coronary artery bypass grafting and/or valvular surgery from the Atrial Fibrillation Suppression Trials I, II, and III.
  
  
  RESULTS
  All variables showing a univariate association (p≤0.20) with AF occurrence were entered into a backward stepwise multivariate logistic regression analysis to control for potential confounders and to calculate adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The population was age 67.8 ± 8.6 (mean ± SD) years and 77.1% male, with CHA2 DS2 -VASc scores of 0-1 (low) in 34 patients (6.1%), 2-3 (medium) in 261 patients (46.6%), and more than 3 (high) in 265 patients (47.3%). Post-CTS AF occurred in 177 patients (31.6%), with 27%, 23%, and 41% in the low-, medium-, and high-CHA2 DS2 -VASc score groups, respectively. The high-score group had a 2.3-fold increased odds of developing AF versus the medium-score group (p<0.0001). The differences between the high- and medium-score groups when each group was compared with the low-score group were not statistically significant. On the multivariate logistic regression analysis, CHA2 DS2 -VASc score was associated with development of AF (AOR 1.20, 95% CI 1.06-1.36).
  
  
  CONCLUSIONS
  Increasing CHA2 DS2 -VASc score was an independent predictor for the development of post-CTS AF, with patients in the high-score group having the highest overall incidence.
authors: School of Pharmacy and Medicine, University of Connecticut, Hartford Hospital, Hartford, CT, USA.
authors: William L
authors: WL
authors: Baker
authors: Craig I
authors: CI
authors: Coleman
authors: C Michael
authors: CM
authors: White
authors: Jeffrey
authors: J
authors: Kluger
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011292:Premedication; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control / Q000532:radiotherapy
chemical_list: D000889:Anti-Arrhythmia Agents