Topcat mobile
However, the predictive ability of the C 2HEST score for stratifying the AF risk has not been previously determined in patients with HFpEF.Īssociations of individual components in the C 2HEST score with adverse outcomes have previously been established in patients with HFpEF. Subsequently, the predictive ability of the C 2HEST score for incident AF has been validated in the healthy Danish population and post-stroke European patients. Within these established risk scoring systems, the C 2HEST score is the latest and simplest one, which has been derived from a large cohort of 471,446 Chinese subjects and validated in a cohort of 514,764 Korean subjects in the community.
A prior systematic review has summarized ten risk scoring models specifically used for predicting incident AF in the general population. The use of a clinical risk stratification score may facilitate targeted efforts to intensify screenings in subjects at high risk of developing AF. However, a clinical risk score for predicting AF in patients with HFpEF remains to be established.
Topcat mobile series#
Several studies have proposed a series of risk scoring models for predicting adverse outcomes such as stroke and death among HFpEF patients. Therefore, HFpEF patients should be screened for AF to prevent adverse cardiovascular events, and early identification of those HFpEF patients at risk of AF may prompt the initiation of stroke prevention treatment and thus improve prognosis. Epidemiological studies have suggested that HFpEF patients are at an increased risk of AF, whereas AF is associated with increased risks of adverse cardiovascular events in HFpEF patients. HFpEF and atrial fibrillation (AF) have many shared risk factors, and thus, they are intertwined disorders and often coexist in clinical settings. Heart failure with preserved ejection fraction (HFpEF) is a highly complex clinical syndrome with a high prevalence that increases with age. Its simplicity may allow the possibility of quick risk assessments in busy clinical settings. The C 2HEST score could predict the risk of incident AF as well as death and hospitalization with moderately good predictive abilities in patients with HFpEF. The AUC for the C 2HEST score in predicting incident AF (0.694, 95% CI 0.640–0.748) was higher than all-cause death, cardiovascular death, any hospitalization, or HF hospitalization. When the C 2HEST score was analyzed as a continuous variable, increased C 2HEST score was associated with increased risk of incident AF (HR 1.50, 95% CI 1.29–1.75), as well as increased risks of all-cause death, cardiovascular death, any hospitalization, and HF hospitalization. The incidence rates of incident AF, stroke, all-cause death, cardiovascular death, any hospitalization, and HF hospitalization were 1.79, 0.70, 3.81, 2.42, 15.50, and 3.32 per 100 person-years, respectively. The discriminative ability of the C 2HEST score for various outcomes was assessed by calculating the area under the curve (AUC). Cox proportional hazard model and competing risk regression model was used to explore the relationship between C 2HEST score and outcomes, including incident AF, stroke, all-cause death, cardiovascular death, any hospitalization, and HF hospitalization.
Topcat mobile trial#
MethodsĪ total of 2202 HFpEF patients without baseline AF in the TOPCAT trial were stratified by baseline C 2HEST score. We aimed to assess whether this risk score could predict incident AF and other clinical outcomes in heart failure with preserved ejection fraction (HFpEF) patients.
The C 2HEST score has been validated for predicting AF in the general population or post-stroke patients.