CHA2DS2-VASc score predicts atrial fibrillation recurrence after cardioversion: systematic review and individual patient pooled meta-analysis.
Clin Cardiol. 2018 Dec 30;:
Authors: Vitali F, Serenelli M, Airaksinen J, Pavasini R, Tomaszuk-Kazberuk A, Mlodawska E, Jaakkola S, Balla C, Falsetti L, Tarquinio N, Ferrari R, Squeri A, Campo G, Bertini M
BACKGROUND: Despite progresses in the treatment of the thromboembolic risk related to atrial fibrillation (AF), the management of recurrences remains a challenge.
HYPOTHESIS: to assess if CHA2 DS2 -VASc score is predictive of early arrhythmia recurrence after AF cardioversion.
METHODS: Systematic review and individual patient pooled meta-analysis following PRISMA guidelines.
INCLUSION CRITERIA: observational trials in patients with AF undergoing cardioversion, available data on recurrence of AF and available data on CHA2 DS2 -VASc score. Clinical studies of interest were retrieved by PUBMED, Cochrane Library and Biomed Central. Seven authors were contacted for joining the patient level meta-analysis, and three shared data regarding anthropometric measurements, risk factors, major comorbidities, CHA2 DS2 -VASc score. The primary outcome was the recurrence of AF after cardioversion in patients free from antiarrhythmic prophylaxis. Univariate and multivariate logistic regression was performed.
RESULTS: Overall we collect data of 2889 patients: 61% were male, 50% with hypertension, 12% with diabetes and 23% with history of ischemic heart disease. The median CHA2DS2-VASc score was 2 [1-3]. At the multivariate analysis, chronic kidney disease (OR 1.94; 95% CI 1.12 - 3.27; p = 0.01), peripheral artery disease (OR 1.65; 95% CI 1.23 - 2.19; p < 0,0001), previous use of beta blockers (OR 1.5; 95% CI 1.19 - 1.88; p < 0.0001), and CHA2DS2-VASc score > 2 (OR 1.37; 95% CI 1.1 - 1.68; p = 0.002) were independent predictors of early recurrence of AF.
CONCLUSIONS: CHA2DS2-VASc score predicts early recurrence of AF in the first 30 days after electrical or pharmacological cardioversion. This article is protected by copyright. All rights reserved.
PMID: 30597581 [PubMed - as supplied by publisher]