Validation of Biomarker-Based ABCD Score in Atrial Fibrillation Patients with a Non-Gender CHA2DS2-VASc Score 0–1: A Korean Multi-Center Cohort

Moonki Jung, Kyeongmin Byeon, Ki Woon Kang, Yae Min Park, You Mi Hwang, Sung Ho Lee, Eun Sun Jin, Seung Young Roh, Jin Seok Kim, Jinhee Ahn, So Ryoung Lee, Eue Keun Choi, Min Soo Ahn, Eun Mi Lee, Hwan Cheol Park, Ki Hong Lee, Min Kim, Joon Hyouk Choi, Jum Suk Ko, Jin Bae KimChangsoo Kim, Gregory Y.H. Lip, Seung Yong Shin

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose: Atrial fibrillation (AF) patients with low to intermediate risk, defined as non-gender CHA2DS2-VASc score of 0–1, are still at risk of stroke. This study verified the usefulness of ABCD score [age (≥60 years), B-type natriuretic peptide (BNP) or N-ter-minal pro-BNP (≥300 pg/mL), creatinine clearance (<50 mL/min/1.73 m2), and dimension of the left atrium (≥45 mm)] for stroke risk stratification in non-gender CHA2DS2-VASc score 0–1. Materials and Methods: This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA2DS2-VASc score 0–1. The primary endpoint was the incidence of stroke with or without antithrombotic therapy (ATT). An ABCD score was validated. Results: Overall, 2694 patients [56.3±9.5 years; female, 726 (26.9%)] were followed-up for 4.0±2.8 years. The overall stroke rate was 0.84/100 person-years (P-Y), stratified as follows: 0.46/100 P-Y for an ABCD score of 0; 1.02/100 P-Y for an ABCD score ≥1. The ABCD score was superior to non-gender CHA2DS2-VASc score in the stroke risk stratification (C-index=0.618, p=0.015; net reclassi-fication improvement=0.576, p=0.040; integrated differential improvement=0.033, p=0.066). ATT was prescribed in 2353 patients (86.5%), and the stroke rate was significantly lower in patients receiving non-vitamin K antagonist oral anticoagulant (NOAC) therapy and an ABCD score ≥1 than in those without ATT (0.44/100 P–Y vs. 1.55/100 P-Y; hazard ratio=0.26, 95% confidence interval 0.11–0.63, p=0.003). Conclusion: The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA2DS2-VASc score 0–1. Furthermore, NOAC with an ABCD score ≥1 was associated with significantly lower stroke rate in AF patients with non-gender CHA2DS2-VASc score 0–1.

Original languageEnglish
Pages (from-to)892-901
Number of pages10
JournalYonsei Medical Journal
Volume63
Issue number10
DOIs
StatePublished - Oct 2022

Bibliographical note

Publisher Copyright:
© Yonsei University College of Medicine 2022.

Keywords

  • ABCD score
  • Atrial fibrillation
  • risk stratification
  • stroke

Fingerprint

Dive into the research topics of 'Validation of Biomarker-Based ABCD Score in Atrial Fibrillation Patients with a Non-Gender CHA2DS2-VASc Score 0–1: A Korean Multi-Center Cohort'. Together they form a unique fingerprint.

Cite this