Assessment of CHADS2 and CHA2DS2-VASc scores in obstructive sleep apnea patients with atrial fibrillation

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• 作者：Filip M. Szymanski ; Krzysztof J. Filipiak ; Anna E. Platek…
• 关键词：Atrial fibrillation ; Obstructive sleep apnea ; Stroke risk ; CHADS2 ; CHA2DS2 ; VASc
• 刊名：Sleep and Breathing
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：19
• 期：2
• 页码：531-537
• 全文大小：300 KB
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• 作者单位：Filip M. Szymanski (1)
  Krzysztof J. Filipiak (1)
  Anna E. Platek (1)
  Anna Hrynkiewicz-Szymanska (2)
  Grzegorz Karpinski (1)
  Grzegorz Opolski (1)
  
  1. Department of Cardiology, Medical University of Warsaw, 1A Banacha Street, Warsaw, 02-097, Poland
  2. Department of Cardiology, Hypertension and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
  
• 刊物主题：Pneumology/Respiratory System; Otorhinolaryngology; Dentistry; Neurology; Internal Medicine; Pediatrics;
• 出版者：Springer Berlin Heidelberg
• ISSN：1522-1709

文摘

Purpose Assessment of stroke risk and implementation of appropriate antithrombotic therapy is an important issue in atrial fibrillation patients. Current risk scores do not take into consideration the comorbidities associated with elevated thromboembolic like obstructive sleep apnea (OSA). The aim of the study was to establish whether atrial fibrillation patients with coexisting OSA have higher stroke risk according to CHADS₂ and CHA₂DS₂-VASc scores. Methods Two hundred fifty-four consecutive patients hospitalized with a primary diagnosis of atrial fibrillation participated in the study. All patients underwent whole night polygraphy and were scored in both CHADS₂ and CHA₂DS₂-VASc according to their medical records or de novo diagnosis. Results The study population was predominantly male (65.4?%; mean age, 57.5?±-0.0?years) with a high prevalence of hypertension (73.6?%), dyslipidemia (63.4?%), and obesity (42.9?%). OSA was present in 47.6?% of patients, who more often had history of stroke (p--.0007). Stroke risk profile assessed by both CHADS₂ and CHA₂DS₂-VASc scores was higher in patients with OSA (1.2?±-.9 vs. 0.8?±-.6; p-lt;-.0001 and 2.2?±-.7 vs. 1.5?±-.1; p--.001) than without it. Differences in the stroke risk remained significant across different age strata, and the trend for point values in CHADS₂ and CHA₂DS₂-VASc scores rose along with OSA severity according to the apnea–hypopnea index (AHI; p for trend <0.001). Conclusions OSA was highly prevalent in atrial fibrillation patients. Patients with OSA have higher CHADS₂ and CHA₂DS₂-VASc scores. Mean CHADS₂ and CHA₂DS₂-VASc scores rise with OSA severity. Future studies should prospectively research on potential inclusion of OSA to stroke prediction models.