Mithat SELVİ, Sevil ÖNAY, Cemil ZENCİR, Çağdaş AKGÜLLÜ, Hasan GÜNGÖR

CHADS2 ve CHA2DS2-VASc Skorları Koroner Arter Bypas Cerrahisi Sonrası Gelişen Atriyal Fibrilasyonunun Öngördürücüsü müdür?

Giriş: Literatürde yeni başlayan atrial fibrilasyon (AF) ya da koroner arter bypas greft (KABG) cerrahisi sonrası gelişen AF'yi öngörmede CHADS2 ve CHA2DS2-VASc skorlarının kullanımı ile ilgili sınırlı sayıda veri mevcuttur.Hastalar ve Yöntem: Merkezimizde KABG cerrahisi yapılan 133 ardışık hasta (42 hasta AF ve AF olmayan 91 hasta) retrospektif olarak incelendi. Hastaların CHADS2 ve CHA2DS2-VASc skor kayıtları incelendi. Bu çalışmanın birincil sonlanım noktası hastane içinde KABG cerrahisi sonrası AF gelişmesiydi.Bulgular: AF grubunda sadece yaş anlamlı olarak yüksek idi (67.6+9.7'ye karşı 62.4+10.6 yıl, p=0.008). Sırasıyla ortalama CHADS2 ve CHA2DS2-VASc skorları 1.53+0.97 ve 3.23+1.25 idi. CHADS2 (1.62+0.91'ye karşı 1.48+1.00, p=0.34) ve CHA2DS2-VASc skorları (3.43+1.17'ye karşı 3.13+1.28, p=0.22) AF grubunda yüksek olmasına rağmen istatistiksel olarak anlamlı değildi. Hastalar CHADS2 ve CHA2DS2-VASc skorları 2 sınır değeri alınıp karşılaştırıldığında AF oranları arasında fark saptanmadı (%31.9'ye karşı %30.0, p=0.55 ve %34.4'ye karşı %24.3, p=0.18). Tek değişkenli ve çok değişkenli analizde sadece yaş KABG cerrahisi sonrası AF'nin öngördürücüsüydü.Sonuç: CHADS2 ve CHA2DS2-VASc skorları KABG cerrahisi sonrası gelişen AF'nin öngördürücüsü değildir.

Anahtar Kelimeler:

atrial fibrilasyon, CHADS2 skoru, CHA2DS2-VASc, koroner arter bypas greft

Are CHADS2 and CHA2DS2-VASc scoring systems useful for predicting postoperative atrial fibrillation after coronary artery bypass graft surgery?

Introduction: In recent literature, limited data exist whether the CHADS2 and CHA2DS2-VASc scores can be used for the prediction of new-onset atrial fibrillation (AF) or AF after coronary artery bypass graft (CABG) surgery.Patients and Methods: We retrospectively analyzed 133 consecutive patients (42 patients with AF and 91 patients without AF) who were undergoing CABG between at our department. Complete medical records were retrospectively collected to investigate CHADS2 and CHA2DS2-VASc scores. The primary end point of this study was the development of AF after CABG surgery.Results: Only age (67.6+9.7 vs 62.4+10.6 years, p=0.008) was significantly higher in AF group. Mean CHADS2 and CHA2DS2-VASc scores were 1.53+0.97 and 3.23+1.25 respectively. CHADS2 (1.62+0.91 vs 1.48+1.00, p=0.34) and CHA2DS2-VASc (3.43+1.17 vs 3.13+1.28, p=0.22) scores were higher in AF group but it was not statistically significant. When patients divided into two groups according to CHADS2 and CHA2DS2-VASc scores at the cuttof point of 2, no significant difference was detected in AF rate (31.9% vs 30.0%, p=0.55 and 34.4% vs 24.3%, p=0.18 respectively). In univariate and multivariate analysis only age was independent predictor of AF after CABG surgery.Conclusion: CHADS2 and CHA2DS2-VASc scores are not independent predictors of AF after CABG surgery.

Keywords:

atrial fibrillation, CHADS2 score, CHA2DS2-VASc, coronary artery bypass graft surgery,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi