Renal dysfunction and the risk of thromboembolic events in patients with atrial fibrillation after catheter ablation - The potential role beyond the CHA2DS2-VASc score

Tze Fan Chao, Hsuan Ming Tsao, Kibos Ambrose, Yenn Jiang Lin, Wei Shiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Kazuyoshi Suenari, Cheng Hung Li, Beny Hartono, Hung Yu Chang, Fa Po Chung, Dicky A. Hanafy, Wen Yu Lin, Shih Ann Chen

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)

Abstract

Background: Renal dysfunction is recognized as an important risk factor for thromboembolic (TE) events in patients with atrial fibrillation (AF) under medical treatment. Objective: To investigate whether renal dysfunction is a useful predictor of TE events among patients receiving AF ablation. We also aimed to determine whether the diagnostic accuracy of the CHA2DS 2-VASc score in predicting TE events could be improved by adding renal dysfunction into the scoring system. Methods: We enrolled a total of 547 patients with AF who underwent catheter ablation. Renal dysfunction was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2. The clinical end point was the occurrence of TE events (ischemic stroke, transient ischemic attack, or other systemic embolisms) during follow-up after catheter ablation. Results: During a follow-up of 38.9 ± 22.5 months, 16 patients (2.9%) experienced TE events. Both the CHA2DS 2-VASc score and renal dysfunction were independent predictors of TE events in the multivariate analysis. Among patients with a CHA 2DS2-VASc score of 0 or 1, renal dysfunction can further stratify them into 2 groups with different event rates (4.3% vs 0.3%; P =.046). A new scoring system derived by assigning 1 more point representing renal dysfunction to the CHA2DS2-VASc score could improve its predictive accuracy; the area under the receiver operating characteristic curve increased from 0.84 to 0.88 (P =.043). Conclusions: Renal dysfunction was a significant risk factor for TE events after catheter ablation of AF and may improve the diagnostic accuracy of the CHA2DS2-VASc score.

Original languageEnglish
Pages (from-to)1755-1760
Number of pages6
JournalHeart Rhythm
Volume9
Issue number11
DOIs
Publication statusPublished - Nov 2012

Keywords

  • Catheter ablation: Atrial fibrillation
  • CHADS-VASc score
  • Renal dysfunction

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