Prognostic role of CHA(2)DS(2)-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation

During the last decade, the CHA(2)DS(2)-VASc score has been used for stratifying the mortality risk in both atrial fibrillation (AF) and non-AF patients. However, no previous study considered this score as a prognostic indicator in non-AF patients with mild-to-moderate idiopathic pulmonary fibrosis...

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Detalles Bibliográficos
Autores principales: Sonaglioni, Andrea, Caminati, Antonella, Re, Margherita, Elia, Davide, Trevisan, Roberta, Granato, Alberto, Zompatori, Maurizio, Lombardo, Michele, Harari, Sergio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Im - Original
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10039767/
https://www.ncbi.nlm.nih.gov/pubmed/36966265
http://dx.doi.org/10.1007/s11739-023-03219-6
Descripción
Sumario:During the last decade, the CHA(2)DS(2)-VASc score has been used for stratifying the mortality risk in both atrial fibrillation (AF) and non-AF patients. However, no previous study considered this score as a prognostic indicator in non-AF patients with mild-to-moderate idiopathic pulmonary fibrosis (IPF). All consecutive non-AF patients with mild-to-moderate IPF, diagnosed between January 2016 and December 2018 at our Institution, entered this study. All patients underwent physical examination, blood tests, spirometry, high-resolution computed tomography and transthoracic echocardiography. CHA(2)DS(2)-VASc score, Gender-Age-Physiology (GAP) index and Charlson Comorbidity Index (CCI) were determined in all patients. Primary endpoint was all-cause mortality, while the secondary endpoint was the composite of all-cause mortality and rehospitalizations for all causes over mid-term follow-up. 103 consecutive IPF patients (70.7 ± 7.3 yrs, 79.6% males) were retrospectively analyzed. At the basal evaluation, CHA(2)DS(2)-VASc score, GAP index and CCI were 3.7 ± 1.6, 3.6 ± 1.2 and 5.5 ± 2.3, respectively. Mean follow-up was 3.5 ± 1.3 yrs. During the follow-up period, 29 patients died and 43 were re-hospitalized (44.2% due to cardiopulmonary causes). On multivariate Cox regression analysis, CHA(2)DS(2)-VASc score (HR 2.15, 95% CI 1.59–2.91) and left ventricular ejection fraction (LVEF) (HR 0.91, 95% CI 0.86–0.97) were independently associated with all-cause mortality in IPF patients. CHA(2)DS(2)-VASc score (HR 1.66, 95% CI 1.39–1.99) and LVEF (HR 0.94, 95% CI 0.90–0.98) also predicted the secondary endpoint in the same study group. CHA(2)DS(2)-VASc score > 4 was the optimal cut-off for predicting both outcomes. At mid-term follow-up, a CHA(2)DS(2)-VASc score > 4 predicts an increased risk of all-cause mortality and rehospitalizations for all causes in non-AF patients with mild-to-moderate IPF.

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