Preoperative CHA2DS2-VASc Score is Associated With Postoperative Survival Following Surgical Ablation Concomitantly With Other Cardiac Surgery

Daniel Julius Lauritzen; Henrik Jensen Vodstrup; Thomas Decker Christensen; Mine Onat Hald; Rasmus Christensen; Johan Heiberg

doi:10.1016/j.hlc.2021.05.076

Preoperative CHA₂DS₂-VASc Score is Associated With Postoperative Survival Following Surgical Ablation Concomitantly With Other Cardiac Surgery

Daniel Julius Lauritzen^*, Henrik Jensen Vodstrup, Thomas Decker Christensen, Mine Onat Hald, Rasmus Christensen, Johan Heiberg

^*Corresponding author for this work

Department of Clinical Medicine - Department of Cardiothoracic and Vascular Surgery

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

BACKGROUND: The CHA₂DS₂-VAScscoring system has been shown to predict long-term outcomes in patients undergoing catheter ablation but has not yet been investigated for patients undergoing surgical ablation. Therefore, the objective was to evaluate the ability of CHA₂DS₂-VASc to predict long-term outcomes after surgical ablation.

METHOD: In a retrospective study, patients were included if they underwent surgical ablation concomitantly with other cardiac surgery. Patients were divided into low-risk (score 0-1), medium-risk (score 2-4) and high-risk (score ≥5) groups based on their CHA₂DS₂-VASc score. Data on survival, atrial fibrillation (AF) recurrence, and stroke were collected retrospectively at the end of the follow-up period.

RESULTS: A total of 587 patients underwent surgical ablation concomitantly with other cardiac surgery. Survival analysis revealed a difference between the three stratified CHA₂DS₂-VASc risk groups, (p<0.001). Similarly, there was a difference in AF recurrence rates between stratified CHA₂DS₂-VASc groups among patients with persistent/long-standing persistent AF (p=0.018). There were no statistically significant differences between stratified CHA₂DS₂-VASc risk groups in terms of recurrence rates of paroxysmal AF or stroke. Finally, the CHA₂DS₂-VASc scoring system was an independent predictor of 5-year mortality after adjusting for potential confounders (hazard ratio 1.25; p=0.002).

CONCLUSIONS: Preoperative CHA₂DS₂-VASc scores were associated with postoperative survival in patients undergoing surgical ablation for AF. Post-hoc analyses showed that CHA₂DS₂-VASc was also a predictor of AF recurrence in patients with persistent/long-standing persistent AF. However, this needs to be confirmed in a prospective study.

Original language	English
Journal	Heart, Lung and Circulation
Volume	30
Issue	12
Pages (from-to)	1942-1948
Number of pages	7
ISSN	1443-9506
DOIs	https://doi.org/10.1016/j.hlc.2021.05.076
Publication status	Published - Dec 2021

Keywords

Arrhythmia
Atrial fibrillation
CHA DS -VASc
Outcome
Surgical ablation

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10.1016/j.hlc.2021.05.076

Cite this

@article{b7d3962f66b8442eb8285d44041f654d,

title = "Preoperative CHA2DS2-VASc Score is Associated With Postoperative Survival Following Surgical Ablation Concomitantly With Other Cardiac Surgery",

abstract = "BACKGROUND: The CHA2DS2-VAScscoring system has been shown to predict long-term outcomes in patients undergoing catheter ablation but has not yet been investigated for patients undergoing surgical ablation. Therefore, the objective was to evaluate the ability of CHA2DS2-VASc to predict long-term outcomes after surgical ablation.METHOD: In a retrospective study, patients were included if they underwent surgical ablation concomitantly with other cardiac surgery. Patients were divided into low-risk (score 0-1), medium-risk (score 2-4) and high-risk (score ≥5) groups based on their CHA2DS2-VASc score. Data on survival, atrial fibrillation (AF) recurrence, and stroke were collected retrospectively at the end of the follow-up period.RESULTS: A total of 587 patients underwent surgical ablation concomitantly with other cardiac surgery. Survival analysis revealed a difference between the three stratified CHA2DS2-VASc risk groups, (p<0.001). Similarly, there was a difference in AF recurrence rates between stratified CHA2DS2-VASc groups among patients with persistent/long-standing persistent AF (p=0.018). There were no statistically significant differences between stratified CHA2DS2-VASc risk groups in terms of recurrence rates of paroxysmal AF or stroke. Finally, the CHA2DS2-VASc scoring system was an independent predictor of 5-year mortality after adjusting for potential confounders (hazard ratio 1.25; p=0.002).CONCLUSIONS: Preoperative CHA2DS2-VASc scores were associated with postoperative survival in patients undergoing surgical ablation for AF. Post-hoc analyses showed that CHA2DS2-VASc was also a predictor of AF recurrence in patients with persistent/long-standing persistent AF. However, this needs to be confirmed in a prospective study.",

keywords = "Arrhythmia, Atrial fibrillation, CHA DS -VASc, Outcome, Surgical ablation",

author = "Lauritzen, {Daniel Julius} and Vodstrup, {Henrik Jensen} and Christensen, {Thomas Decker} and Hald, {Mine Onat} and Rasmus Christensen and Johan Heiberg",

note = "Copyright {\textcopyright} 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.",

year = "2021",

month = dec,

doi = "10.1016/j.hlc.2021.05.076",

language = "English",

volume = "30",

pages = "1942--1948",

journal = "Heart, Lung and Circulation",

issn = "1443-9506",

publisher = "Elsevier Ltd",

number = "12",

}

Preoperative CHA₂DS₂-VASc Score is Associated With Postoperative Survival Following Surgical Ablation Concomitantly With Other Cardiac Surgery. / Lauritzen, Daniel Julius; Vodstrup, Henrik Jensen; Christensen, Thomas Decker et al.
In: Heart, Lung and Circulation, Vol. 30, No. 12, 12.2021, p. 1942-1948.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Preoperative CHA2DS2-VASc Score is Associated With Postoperative Survival Following Surgical Ablation Concomitantly With Other Cardiac Surgery

AU - Lauritzen, Daniel Julius

AU - Vodstrup, Henrik Jensen

AU - Christensen, Thomas Decker

AU - Hald, Mine Onat

AU - Christensen, Rasmus

AU - Heiberg, Johan

N1 - Copyright © 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

PY - 2021/12

Y1 - 2021/12

N2 - BACKGROUND: The CHA2DS2-VAScscoring system has been shown to predict long-term outcomes in patients undergoing catheter ablation but has not yet been investigated for patients undergoing surgical ablation. Therefore, the objective was to evaluate the ability of CHA2DS2-VASc to predict long-term outcomes after surgical ablation.METHOD: In a retrospective study, patients were included if they underwent surgical ablation concomitantly with other cardiac surgery. Patients were divided into low-risk (score 0-1), medium-risk (score 2-4) and high-risk (score ≥5) groups based on their CHA2DS2-VASc score. Data on survival, atrial fibrillation (AF) recurrence, and stroke were collected retrospectively at the end of the follow-up period.RESULTS: A total of 587 patients underwent surgical ablation concomitantly with other cardiac surgery. Survival analysis revealed a difference between the three stratified CHA2DS2-VASc risk groups, (p<0.001). Similarly, there was a difference in AF recurrence rates between stratified CHA2DS2-VASc groups among patients with persistent/long-standing persistent AF (p=0.018). There were no statistically significant differences between stratified CHA2DS2-VASc risk groups in terms of recurrence rates of paroxysmal AF or stroke. Finally, the CHA2DS2-VASc scoring system was an independent predictor of 5-year mortality after adjusting for potential confounders (hazard ratio 1.25; p=0.002).CONCLUSIONS: Preoperative CHA2DS2-VASc scores were associated with postoperative survival in patients undergoing surgical ablation for AF. Post-hoc analyses showed that CHA2DS2-VASc was also a predictor of AF recurrence in patients with persistent/long-standing persistent AF. However, this needs to be confirmed in a prospective study.

AB - BACKGROUND: The CHA2DS2-VAScscoring system has been shown to predict long-term outcomes in patients undergoing catheter ablation but has not yet been investigated for patients undergoing surgical ablation. Therefore, the objective was to evaluate the ability of CHA2DS2-VASc to predict long-term outcomes after surgical ablation.METHOD: In a retrospective study, patients were included if they underwent surgical ablation concomitantly with other cardiac surgery. Patients were divided into low-risk (score 0-1), medium-risk (score 2-4) and high-risk (score ≥5) groups based on their CHA2DS2-VASc score. Data on survival, atrial fibrillation (AF) recurrence, and stroke were collected retrospectively at the end of the follow-up period.RESULTS: A total of 587 patients underwent surgical ablation concomitantly with other cardiac surgery. Survival analysis revealed a difference between the three stratified CHA2DS2-VASc risk groups, (p<0.001). Similarly, there was a difference in AF recurrence rates between stratified CHA2DS2-VASc groups among patients with persistent/long-standing persistent AF (p=0.018). There were no statistically significant differences between stratified CHA2DS2-VASc risk groups in terms of recurrence rates of paroxysmal AF or stroke. Finally, the CHA2DS2-VASc scoring system was an independent predictor of 5-year mortality after adjusting for potential confounders (hazard ratio 1.25; p=0.002).CONCLUSIONS: Preoperative CHA2DS2-VASc scores were associated with postoperative survival in patients undergoing surgical ablation for AF. Post-hoc analyses showed that CHA2DS2-VASc was also a predictor of AF recurrence in patients with persistent/long-standing persistent AF. However, this needs to be confirmed in a prospective study.

KW - Arrhythmia

KW - Atrial fibrillation

KW - CHA DS -VASc

KW - Outcome

KW - Surgical ablation

U2 - 10.1016/j.hlc.2021.05.076

DO - 10.1016/j.hlc.2021.05.076

M3 - Journal article

C2 - 34088628

SN - 1443-9506

VL - 30

SP - 1942

EP - 1948

JO - Heart, Lung and Circulation

JF - Heart, Lung and Circulation

IS - 12