Carotid plaque detection improves the predictve value of CHA2DS2-VASc score in patients with non-valvular atrial fibrilation: The ARAPACIS Study

6533b7d3fe1ef96bd12615c5

RESEARCH PRODUCT

Carotid plaque detection improves the predictve value of CHA2DS2-VASc score in patients with non-valvular atrial fibrilation: The ARAPACIS Study

Stefania Basili Lorenzo Loffredo Daniele Pastori Marco Proieti Alessio Farcomeni Anna Rta Vesti Pasquale Pignatelli Giovanni Davì William R. Hiatt Gregory Y. H. Lip Gino R. Corazza Francesco Perticone Francesco Violi C. Alessandri G. Serviddio S. Fascetti P. Palange E. Greco G. Bruno M. Averna A. Giammanco P. Sposito R. De Cristofaro L. De Gennaro L. Carulli E. Pellegrini L. Cominacini C. Mozzini A. F. Pasini M. Sprovieri V. Spagnuolo G. Cerqua G. Cerasola G. Mule M. Barbagallo S. Lo Sciuto A. Monteverde A. Saitta A. Lo Gullo L. Malatino C. Ciia V. Terranova M. Pisano A. Pinto D. Di Raimondo A. Tuttolomondo R. Conigliaro S. Signorelli D. De Palma M. Galderisi G. Cudemo F. Galletti V. Fazio N. De Luca A. Meccariello D. Caputo M. T. De Donato A. Iannuzi A. Bresciani R. Giunta R. Utili V. Iorio L. E. Adinolfi C. Sellitto N. Iuliano P. Bellis P. Tirelli D. Sacerdoti D. Vanni L. Iuliano M. Ciacciarelli A. Pacelli A. Palazzuoli M. Cacciafesta N. Gueli G. Lo Iacono S. Brusco W. Verrusio L. Nobili N. Tarquinio F. Pellegrini G. M. Vincentelli F. Ravallese C. Santini C. Letizia L. Petramala L. Zinnamosca S. Minisola M. Cilli C. Savoriti L. Colangelo P. Falaschi A. Martocchia F. Pastore G. Bertazzoni E. Attalla El Halabieh M. Paradiso E. M. Lizzi S. Timmi P. Battisti S. Cerci M. Ciavolella C. Di Veroli F. Malei A. De Ciocchis D. Abate P. Castellino L. Zanoli F. Fidone E. T. Mannarino L. Pasqualini G. Oliverio A. Pende N. Aitom R. Ricchio F. L. Fimognari M. Alletto S. Messina G. Sesti F. Arturi T. V. Fiorentino E. Pedace P. E. Scarpino G. Carullo R. Maio A. Sciacqua P. Frugiuele V. Spagnuolo G. Battaglia S. Atzori G. Delitala E. Angelucci S. Sestili G. Traisci L. De Feudis D. Di Michèle A. Fava C. Balsano P. De Ciantis G. Desideri A. Camerota M. Mezzetti P. Gresele C. Vedovati T. Fierro L. Puccetti M. Bertolotti C. Mussi M. Boddi A. Savino S. Contri G. Degl'innocenti A. Sailer F. Fabris R. Pesavento L. Filippi V. Vedovetto M. Puato F. Fabris M. Treleani E. De Luca F. De Zaiacomo V. Giantin A. Semplicini P. Minuz S. Romano F. Fantin A. Manica I. Stockner P. Pattis B. Gutmann C. Catena G. Colussi L. A. Sechi G. Annoni A. A. Bruni A. Castagna D. Spinelli E. Miceli D. Paduia G. Schinco S. Spreafico B. Secchi M. Vanoli G. Casella E. A. Pulixi L. Sansone M. G. Serra S. Longo S. Antonaci A. Belfiäore M. Frualdo G. Palasciano L. Ricci F. Ventrella C. Bianco D. Santovito F. Cipollone S. Nicolai F. Salvati G. B. Rini F. Scozzari M. L. Muiesan M. Salvetti A. Bazza A. Picardi U. Vespasiani-gentilucci A. De Vincentis P. Cosio M. Terzolo B. Madaffari B. Parasporo L. Fenoglio C. Bracco R. Melchio T. Gentili A. Salvi C. Nitti A. Gabrielli G. P. Martino A. Capucci M. Brambatti A. Sparagna D. Tirotta P. Andreozzi E. Ettorre G. Viscogliosi A. Servello M. Musumeci F. Rossi Fanelli M. Delfino A. Giorgi N. Glorioso G. Melis G. Marras M. Matta A. Sacco E. Stellitano A. Scordo F. Russo A. A. Caruso E. Porreca M. Tana C. Ferri P. Cheli P. Portincasa G. Muscianisi S. Giordani V. Stanghellini C. Sabbà G. Mancuso M. Bartone D. Calipari G. Arcidiacono I. Bellanuova M. Ferraro G. Marigliano D. Cozzolino A. Lampitella V. Acri D. Galasso F. Mazzei S. Galasso A. Buratti M. Porta M. F. Brizzi A. Fattorini F. Sampietro A. D'angelo R. Manfredini M. Pala F. Fabbian C. Moroni L. Valente F. Lopreiato F. Parente M. Granata M. Moia S. Braham M. Rossi M. Pesce A. Gentile V. Catozzo G. Baciarello A. Cosimati W. Ageno E. Rancan L. Guasti A. Ciccaglioni S. Negri M. Polselli D. Prisco R. Marcucci D. Ferro R. Cangemi L. Perri L. Polimeni E. Catasca T. Vicario R. Russo M. Saliola M. Del Ben F. Ange-lico C. Calvieri T. Bucci F. Baratta R. Migliacci G. Porciello S. Corrao F. S. Pignataro L. Napoleone G. Talerico D. Amoroso G. F. Romiti E. Ruscio F. Toriello T. Todisco G. Di Tanna M. L. Saccheti P. E. Puddu M. Anzaldi C. Bazzini P. I. Bianchi B. Boari G. Bracco A. Buonauro C. Butta E. Buzzetti S. Calabria W. Capeci F. Caradio P. Carleo M. D. Carrabba L. Castorani L. Cecchetto S. Cicco C. Cimini B. M. Colombo A. De Giorgi S. De Vuono L. Del Corso A. Denegri P. Di Giosia E. Durante Mangoni L. Falsetti A. Forgione P. Giorgini D. Grassi A. Grembiale D. Hijazi L. Iamele G. Lorusso A. Marchese A. M. Marra M. Masala G. Miceli L. Montebianco Abenavoli G. Murgia P. Naccarato D. Paduia P. Pattoneri F. Perego P. Pesce S. Piano M. Pinna D. Pinto V. Pretti G. Pucci V. Raparelli F. Salinaro A. Salzano F. Santilli F. Scarpini R. Scicali D. Sirico P. Suppressa M. Talia E. J. Tassone D. Torres N. Vazzana C. R. Vecchio G. Vidili F. Vitale V. Zaccone Simi Young Internists Gis Group

subject

Atherosclerosis Atrial fibrillation Carotid plaque CHA2DS2-VASc score Stroke Vascular disease Carotid Artery Diseases Male Atherosclerosis; Atrial fibrillation; Carotid plaque; CHA2DS2-VASc score; Stroke; Vascular disease; Aged; Aged 80 and over; Ankle Brachial Index; Atrial Fibrillation; Carotid Artery Diseases; Female; Humans; Incidence; Italy; Male; Plaque Atherosclerotic; Retrospective Studies; Risk Factors; Survival Rate; Ultrasonography Doppler; Risk Assessment; Cardiology and Cardiovascular Medicine 030204 cardiovascular system & hematology atrialf fibrillation 0302 clinical medicine Retrospective Studie Risk Factors Carotid artery disease Atherosclerosis; Atrial fibrillation; Carotid plaque; CHA; 2; DS; 2; -VASc score; Stroke; Vascular disease; Aged; Aged 80 and over; Ankle Brachial Index; Atrial Fibrillation; Carotid Artery Diseases; Female; Humans; Incidence; Italy; Male; Plaque Atherosclerotic; Retrospective Studies; Risk Factors; Survival Rate; Ultrasonography Doppler; Risk Assessment Atrial Fibrillation 80 and over 030212 general & internal medicine Myocardial infarction Stroke DS Atherosclerosis; Atrial fibrillation; CHA(2)DS(2)-VASc score; Carotid plaque; Stroke; Vascular disease; Aged; Aged 80 and over; Ankle Brachial Index; Atrial Fibrillation; Carotid Artery Diseases; Female; Humans; Incidence; Italy; Male; Plaque Atherosclerotic; Retrospective Studies; Risk Factors; Survival Rate; Ultrasonography Doppler; Risk Assessment CHA 2 DS 2 -VASc score Plaque Atherosclerotic Ultrasonography Aged 80 and over Incidence Doppler Atrial fibrillation Carotid plaque Plaque Atherosclerotic Stroke Survival Rate Italy Atherosclerosi CHA(2)DS(2)-VASc score Cardiology artherosclerosis; atrial fibrillation; carotid plaque; CHA2DS2-VASc score; stroke; vascular disease; aged; aged 80 and over; ankle brachial index; atrialf fibrillation; carotid artery diseases; female; humans; incidence; italy; male; plaque atherosclerotic; retrospective studies; risk factors; survival rate; ultrasonography doppler; risk assessment; cardiology and cardiovascular medicine Female Settore SECS-S/01 - Statistica Cardiology and Cardiovascular Medicine Human medicine.medical_specialty CHA2DS2-VASc score 2 Atherosclerosis; Atrial fibrillation; Carotid plaque; CHA 2 DS 2 -VASc score ; Stroke; Vascular disease; Aged; Aged 80 and over; Ankle Brachial Index; Atrial Fibrillation; Carotid Artery Diseases; Female; Humans; Incidence; Italy; Male; Plaque Atherosclerotic; Retrospective Studies; Risk Factors; Survival Rate; Ultrasonography Doppler; Risk Assessment; Cardiology and Cardiovascular Medicine Socio-culturale Vascular disease Risk Assessment -VASc score 03 medical and health sciences Internal medicine medicine Humans Ankle Brachial Index cardiovascular diseases Risk factor Survival rate Aged Retrospective Studies Carotid Artery Disease Vascular disease business.industry Risk Factor Ultrasonography Doppler medicine.disease Atherosclerosis artherosclerosis CHA2DS2–VASc score CHA Atherosclerosis; Atrial fibrillation; Carotid plaque; CHA; 2; DS; 2; -VASc score; Stroke; Vascular disease business

description

Abstract Background and aims Vascular disease (VD), as assessed by history of myocardial infarction or peripheral artery disease or aortic plaque, increases stroke risk in atrial fibrillation (AF), and is a component of risk assessment using the CHA 2 DS 2 -VASc score. We investigated if systemic atherosclerosis as detected by ultrasound carotid plaque (CP) could improve the predictive value of the CHA 2 DS 2 -VASc score. Methods We analysed data from the ARAPACIS study, an observational study including 2027 Italian patients with non-valvular AF, in whom CP was detected using Doppler Ultrasonography. Results VD was reported in 351 (17.3%) patients while CP was detected in 16.6% patients. Adding CP to the VD definition leaded to higher VD prevalence (30.9%). During a median [IQR] follow-up time of 36months, 56 (2.8%) stroke/TIA events were recorded. Survival analysis showed that conventional VD alone did not increase the risk of stroke (Log-Rank: 0.009, p=0.924), while addition of CP to conventional VD was significantly associated to an increased risk of stroke (LR: 5.730, p=0.017). Cox regression analysis showed that VD+CP was independently associated with stroke (HR: 1.78, 95% CI: 1.05–3.01, p=0.0318). Reclassification analysis showed that VD+CP allowed a significant risk reclassification when compared to VD alone in predicting stroke at 36months (NRI: 0.192, 95% CI: 0.028–0.323, p=0.032). Conclusions In non-valvular AF patients the addition of ultrasound detection of carotid plaque to conventional VD significantly increases the predictive value of CHA 2 DS 2 -VASc score for stroke.

year	journal	country	edition	language
2017-03-01

10.1016/j.ijcard.2017.01.001 http://hdl.handle.net/11577/3337788