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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer International Publishing
2023
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Materias: | |
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 |
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author | Sonaglioni, Andrea Caminati, Antonella Re, Margherita Elia, Davide Trevisan, Roberta Granato, Alberto Zompatori, Maurizio Lombardo, Michele Harari, Sergio |
author_facet | Sonaglioni, Andrea Caminati, Antonella Re, Margherita Elia, Davide Trevisan, Roberta Granato, Alberto Zompatori, Maurizio Lombardo, Michele Harari, Sergio |
author_sort | Sonaglioni, Andrea |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10039767 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-100397672023-03-27 Prognostic role of CHA(2)DS(2)-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation Sonaglioni, Andrea Caminati, Antonella Re, Margherita Elia, Davide Trevisan, Roberta Granato, Alberto Zompatori, Maurizio Lombardo, Michele Harari, Sergio Intern Emerg Med Im - Original 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. Springer International Publishing 2023-03-25 2023 /pmc/articles/PMC10039767/ /pubmed/36966265 http://dx.doi.org/10.1007/s11739-023-03219-6 Text en © The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI) 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Im - Original Sonaglioni, Andrea Caminati, Antonella Re, Margherita Elia, Davide Trevisan, Roberta Granato, Alberto Zompatori, Maurizio Lombardo, Michele Harari, Sergio Prognostic role of CHA(2)DS(2)-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation |
title | Prognostic role of CHA(2)DS(2)-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation |
title_full | Prognostic role of CHA(2)DS(2)-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation |
title_fullStr | Prognostic role of CHA(2)DS(2)-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation |
title_full_unstemmed | Prognostic role of CHA(2)DS(2)-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation |
title_short | Prognostic role of CHA(2)DS(2)-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation |
title_sort | prognostic role of cha(2)ds(2)-vasc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation |
topic | Im - Original |
url | 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 |
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