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SCORE2 and SCORE2-OP Assessment in the Predicting of Cardiovascular Diseases and AF Recurrence in Hypertensive AF
Gülhan Yüksel1, Mustafa Lütfullah Ardıç1, Hilmi Erdem Sumbul2
1Department of Cardiology, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, Turkey.
Insights
SCORE2 and SCORE2-OP risk scores can predict cardiovascular disease (CVD) and atrial fibrillation (AF) recurrence after catheter ablation in hypertensive patients. Higher risk scores indicate increased likelihood of adverse events, guiding personalized treatment strategies.
Area of Science:
- Cardiology
- Preventive Medicine
- Medical Risk Assessment
Background:
- Hypertension (HT) is a significant modifiable risk factor for cardiovascular disease (CVD) in patients with atrial fibrillation (AF).
- Current risk stratification tools lack data for AF patients undergoing catheter ablation (CA).
- The study investigates the utility of SCORE2 and SCORE2-OP risk scores in this specific population.
Purpose of the Study:
- To evaluate the effectiveness of SCORE2 and SCORE2-OP risk scores in predicting AF recurrence and CVD development post-CA.
- To assess the association between pre-procedural risk scores and clinical outcomes in patients with paroxysmal AF and HT.
Main Methods:
- Retrospective cohort study of 266 patients with paroxysmal AF undergoing CA.
- Patients categorized into risk groups (<5%, 5%–<10%, ≥10%) based on SCORE2 and SCORE2-OP.
- Primary endpoint: adverse CVD; Secondary endpoint: AF recurrence.
Main Results:
- Higher CVD risk groups (≥10%) showed significantly increased frequencies of CVD (15%) and AF recurrence (25%).
- Independent predictors for CVD included high risk score (≥10%), CHA2DS2-VA, and uric acid.
- Independent predictors for AF recurrence included high risk score (≥10%) and left atrial end-diastolic diameter (LAd).
Conclusions:
- SCORE2 and SCORE2-OP algorithms are valuable tools for predicting AF recurrence and CVD development in hypertensive patients undergoing CA for paroxysmal AF.
- These risk scores can aid in risk stratification and personalized management strategies.
- Further research is needed to validate these findings in a broader AF patient population.
Abstract:
Background/aims: Hypertension (HT) is a modifiable risk factor for the development of cardiovascular disease (CVD) in patients with atrial fibrillation (AF). There are no data on the use of the SCORE2 and SCORE2-OP risk scores used in patients with AF. In our study, we aimed to determine the effect of SCORE2 and SCORE2-OP risk scores on AF recurrence and CVD development after catheter ablation (CA) in AF patients with HT. Methods: This retrospective cohort study included 266 patients (144 men, 122 women, 57.1 ± 11 years) who underwent CA with a diagnosis of paroxysmal AF. Patients were grouped as <5%-5% to <10%-≥10% (Group I-II-III, respectively) according to CVD risk in SCORE2 and SCORE2-OP. The primary endpoint was adverse CVD. The secondary endpoint was AF recurrence. Results: The frequency of CVD and AF recurrence in groups I-II-III was 0(0%)-8(8%)-14(15%) and 9(13%)-17(16%)-23(25%), respectively (p = 0.001 and p = 0.035). Age, systolic blood pressure, presence of CVD risk ≥ 10%, CHA2DS2-VA, BUN, and uric acid were found to be higher in those with CVD. In logistic regression analysis, the presence of CVD risk ≥ 10%, CHA2DS2-VA and uric acid were found to independently predict the development of CVD (OR = 3.960, 95%CI-1.098-8.508, p = 0.019, OR = 3.257, 95%CI-1.067-7.318, p = 0.015 and OR = 1.967, 95%CI-1.359-2.873, p = 0.001). Triglycerides, CVD risk of ≥10%, and left atrial end-diastolic diameter (LAd) were found to be higher in those with AF recurrence. In regression analysis, the presence of CVD risk ≥ 10% and LAd were found to independently determine the development of AF recurrence (OR = 2.448, 95%CI-0.993-1.023, p = 0.005, OR = 1.217, 95%CI-1.124-1.319). Conclusions: SCORE2 and SCORE2-OP algorithms performed before the procedure in isolated HT patients undergoing ablation for paroxysmal AF can be used to predict AF recurrence and CVD development. The SCORE2 and SCORE2-OP algorithms have been evaluated exclusively in patients with isolated hypertension; therefore, further studies are needed to determine their applicability in the broader atrial fibrillation population.
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