CHA_(2)DS_(2)-VAS_(C)评分对冠状动脉旁路移植术后心房颤动的预测价值  

Evaluation of CHA_(2)DS_(2)-VAS_(C) score for new onset postoperative atrial fibrillation after isolated coronary artery bypass graft surgery

作　　者：陈丽竹 戴雯莉[2] 李松南[2] CHEN Lizhu;DAI Wenli;LI Songnan(Department of Cardiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院心内科,100050 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科

出　　处：《心肺血管病杂志》2021年第3期229-232,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨CHA_(2)DS_(2)-VAS_(C)评分对冠状动脉旁路移植术(CABG)后新发心房颤动(POAF)的预测价值。方法:收集2018年4月至2019年4月,行CABG术患者755例的临床资料,根据术后是否POAF分为POAF组和no-POAF组,比较两组患者的临床指标以及CHA_(2)DS_(2)-VAS_(C)评分,绘制工作特征曲线(ROC)评价CHA_(2)DS_(2)-VAS_(C)评分对POAF的预测价值。结果:POAF组患者CHA_(2)DS_(2)-VAS_(C)评分显著高于no-POAF组(P=0.000)。Logistic回归分析显示CHA_(2)DS_(2)-VAS_(C)评分是POAF的危险因素(OR=1.81,95%CI:1.58~2.06),预测POAF的ROC曲线下面积为70.5%(95%CI:0.665~0.744),当评分≥3分时,预测价值最高,灵敏度为59.2%,特异度为68.9%。结论:术前CHA_(2)DS_(2)-VAS_(C)评分对POAF有一定预测价值,评分越高,POAF发生风险可能越高。Objective: To evaluate the performance of CHA_(2)DS_(2)-VAS_(C) score as a prediction tool for new onset postoperative atrial fibrillation(POAF) after isolated coronary artery bypass graft(CABG) surgery. Methods: 755 patients undergoing isolated CABG surgery were analyzed. Medical records were retrospectively collected to investigate CHA_(2)DS_(2)-VAS_(C) score. All patients were divided into two groups: POAF group and no-POAF group. The clinical indicators and CHA_(2)DS_(2)-VAS_(C) score were compared between two groups. The receiver operating characteristic curve(ROC) was used to evaluate the prediction value of CHA_(2)DS_(2)-VAS_(C) score for POAF after CABG. Results: CHA_(2)DS_(2)-VAS_(C) score was significantly higher in POAF group(P=0.000). Logistic regression analysis showed that CHA_(2)DS_(2)-VAS_(C) score(OR 1.81,95%CI:1.58-2.06) was an independent predictor of POAF after CABG surgery. ROC analysis showed that the cut-off point of CHA_(2)DS_(2)-VAS_(C) score related to predict POAF was 3 or more, with a sensitivity of 59.2% and specificity of 68.9%. Conclusions: CHA_(2)DS_(2)-VAS_(C) score may help to predict POAF after CABG surgery. Patients with elevated preoperative CHA_(2)DS_(2)-VAS_(C) score may have higher risk for POAF.

关 键 词：CHA_(2)DS_(2)-VAS_(C)评分 冠状动脉旁路移植术 术后心房颤动 

分 类 号：R54[医药卫生—心血管疾病]