Clinical Electrophysiology -> Atrial Fibrillation & Atrial Flutter: -> Pharmacology (Antiarrhythmic drugs and anticoagulants) D-AB26 - Refining Stroke Prevention in Atrial Fibrillation (ID 13) Abstract

D-AB26-05 - External Validation Of The Biomarker-based ABCD Score In ‘Low Risk’ Atrial Fibrillation Patients With Non-gender CHA2DS2-VASc Score 0-1 For Further Stroke Risk Refinement (ID 1464)

Abstract

Background: ‘Low risk’ atrial fibrillation (AF) patients with non-gender CHA2DS2-VASc score 0-1 may still be at risk of stroke. Biomarkers may help further risk stratification.
Objective: Our aim was to externally validate the usefulness of the previously proposed ABCD score [Age (≥ 60 years), NT-proBNP (≥ 300 pg/ml), Creatinine clearance (< 50 ml/min), and left atrial Dimension (≥ 45 mm)] for predicting ischemic stroke in patients with non-gender CHA2DS2-VASc score 0-1.
Methods: We analyzed AF patients with non-gender CHA2DS2-VASc score 0-1 in Chung-Ang University Hospital between January 1st, 2013 and December 31st, 2018. The primary endpoint was incident of ischemic stroke with or without anti-thrombotic treatment (anti-platelet [APT] or oral anti-coagulation [OAC]).
Results: Total 448 patients (mean age 59.1 ± 9.8 years, male 300 [67.0 %]) were followed-up over 3.2 years. Overall ischemic stroke rate was 2.38 per 100 person-years [P-Y], which was further stratified as follows: 0.58 / 100 P-Y with ABCD score 0 [n = 98], 2.96 / 100 P-Y with ABCD score 1 or more [n = 350], C-statistic = 0.601, P = 0.05). OAC was prescribed in 270 patients (77.1 %) with ABCD score ≥1 and stroke rate was significantly lower in patients with OAC (6.41 /100 P-Y in no treatment vs. 7.67 / 100 P-Y in APT vs. 1.85 / 100 P-Y in OAC, P = 0.013).
Conclusion: The biomarker-based ABCD score was useful for refining truly low stroke risk amongst AF patients with non-gender CHA2DS2-VASc score 0-1. OAC use in ABCD score ≥1 was associated with lower ischemic stroke in AF patients with non-gender CHA2DS2-VASc score 0-1.
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