Usefulness of the Addition of Renal Function to the CHA2DS2-VASc Score as a Predictor of Thromboembolism and Mortality in Patients Without Atrial Fibrillation

Research is conflicting whether kidney function should be incorporated in thromboembolism risk prediction. Our published data showed that the CHA2DS2-VASc score predicts thromboembolism and mortality in those without atrial fibrillation. We used the Rochester Epidemiology Project medical records sys...

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Bibliographic Details
Published in:The American journal of cardiology 2018-08, Vol.122 (4), p.597-603
Main Authors: Parsons, Christine, Cha, Stephen, Shen, Win-Kuang, Chamberlain, Alanna M., Luis, Sushil Allen, Keddis, Mira, Shamoun, Fadi
Format: Article
Language:English
Subjects:
Aged
Atrial Fibrillation
Cardiac arrhythmia
Confidence intervals
Correlation analysis
Electrocardiography
Epidemiology
Female
Fibrillation
Follow-Up Studies
Glomerular filtration rate
Glomerular Filtration Rate - physiology
Humans
Impairment
Kidney diseases
Kidneys
Male
Medical records
Minnesota - epidemiology
Monitoring, Physiologic - methods
Mortality
Patients
Population
Predictions
Prognosis
Renal function
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - physiopathology
Retrospective Studies
Risk Assessment - methods
Risk Factors
Standard deviation
Stroke
Survival Rate - trends
Thromboembolism
Thromboembolism - diagnosis
Thromboembolism - etiology
Thromboembolism - mortality
Time Factors
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Summary:Research is conflicting whether kidney function should be incorporated in thromboembolism risk prediction. Our published data showed that the CHA2DS2-VASc score predicts thromboembolism and mortality in those without atrial fibrillation. We used the Rochester Epidemiology Project medical records system to retrospectively evaluate whether adding renal impairment (1 point) to the CHA2DS2-VASc score (-R) enhances the score's prediction of mortality, thromboembolism, and atrial fibrillation in patients without atrial fibrillation. We identified patients that had an implantable cardiac monitoring device placed from January 1, 2004 to December 31, 2013, which was defined as the start date. Follow-up was through March 7, 2016. An implantable device was required to discern the absence of atrial fibrillation. Renal impairment was defined as chronic kidney disease stage 3 or greater. The population (n = 1,606) had a mean age of 69.8 years and median follow-up of 4.8 years. Baseline renal impairment was predictive of mortality (hazard ratio [HR] 2.06, 95% confidence interval [CI] 1.64 to 2.60, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2018.04.049