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CHA2DS2-VASc Score Predicts Adverse Outcome in Patients with Simple Congenital Heart Disease Regardless of Cardiac

Giorgio Faganello1, Giulia Barbati2, Giulia Russo3

  • 1Azienda Sanitaria Universitaria Integrata di Trieste, Via Slataper n°9, 34134, Trieste, Italy. giorgio.faganello@libero.it.

Pediatric Cardiology
|May 7, 2020
PubMed

Insights

The CHA2DS2-VASc score effectively predicts adverse events in adults with simple congenital heart disease (sACHD), regardless of their heart rhythm. This score helps stratify long-term clinical risks for this growing patient population.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease (ACHD)

Background:

  • Adult patients with simple congenital heart disease (sACHD) are an increasing population at risk for atrial arrhythmias (AA).
  • The CHA2DS2-VASc score is established for estimating thromboembolic risk in non-valvular atrial fibrillation.

Purpose of the Study:

  • To evaluate the prognostic value of the CHA2DS2-VASc score in a broad sACHD population.
  • To assess the score's utility irrespective of the patient's current cardiac rhythm.

Main Methods:

  • A cohort of 427 sACHD patients (November 2009-June 2018) was analyzed.
  • Patients were categorized by CHA2DS2-VASc score (0-1 vs. >1).
  • Composite primary endpoint: cardiovascular hospitalization and/or all-cause death over a mean 70-month follow-up.

Main Results:

  • Patients with CHA2DS2-VASc score >1 (Group B) were older and had more risk factors.
  • The primary endpoint occurred in 22% of patients, significantly higher in Group B (37%) versus Group A (10%).
  • CHA2DS2-VASc score independently predicted the primary endpoint in the overall cohort and in those with sinus rhythm.

Conclusions:

  • The CHA2DS2-VASc score is a valuable tool for risk stratification in sACHD patients.
  • Its prognostic capability extends to patients regardless of their cardiac rhythm, including those in sinus rhythm.
  • The score aids in identifying sACHD patients at higher risk for long-term adverse clinical events.

Keywords:
CHA2DS2-VASc scoreCardiac rhythmCongenital heart diseaseHeart failure

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