Background and aims: Vascular disease (VD), as assessed by history of myocardial infarction or peripheral artery disease or aortic plaque, increases stroke risk in atrial fibrillation (AF), and is a component of risk assessment using the CHA2DS2-VASc score. We investigated if systemic atherosclerosis as detected by ultrasound carotid plaque (CP) could improve the predictive value of the CHA2DS2-VASC score. Methods: We analysed data from the ARAPACIS study, an observational study including 2027 Ialian patents with non-valvular AF, in whom CP was detected using Doppler Ultrasonography. Results: VD was reported in 351 (17.3%) patients while CP was detected in 16.6% patents. Adding CP to the VD definition leaded to higher VD prevalence (30.9%). During a median [IQR] follow-up time of 36 months, 56 (2.8%) stroke/TIA events were recorded. Survival analysis showed that conventional VD alone did not increase the risk of stroke (Log-Rank: 0.009, p = 0.924), while addition of CP to conventional VD was significantly associated to an increased risk of stroke (LR: 5.730, p = 0.017). Cox regression analysis showed that VD + CP was independently associated with stroke (HR: 1.78, 95% CI: 1.05-3.01, p = 0.0318). Reclassification analysis showed that VD + CP allowed a significant risk reclassification when compared to VD alone in predicting stroke at 36 months (NRI: 0.192, 95% CI: 0.028-0.323, p = 0.032). Conclusions: In non-valvular AF patients the addition of ultrasound detection of carotid plaque to conventional VD significantly increases the pedictive value of CHA2DS2-VASc score for stroke.
Basili, S., Loffredo, L., Pastori, D., Proieti, M., Farcomeni, A., Vesti, A., et al. (2017). Carotid plaque detection improves the predictve value of CHA2DS2-VASc score in patients with non-valvular atrial fibrilation: The ARAPACIS Study. INTERNATIONAL JOURNAL OF CARDIOLOGY, 231, 143-149 [10.1016/j.ijcard.2017.01.001].
Citazione: | Basili, S., Loffredo, L., Pastori, D., Proieti, M., Farcomeni, A., Vesti, A., et al. (2017). Carotid plaque detection improves the predictve value of CHA2DS2-VASc score in patients with non-valvular atrial fibrilation: The ARAPACIS Study. INTERNATIONAL JOURNAL OF CARDIOLOGY, 231, 143-149 [10.1016/j.ijcard.2017.01.001]. | |
Tipo: | Articolo in rivista - Articolo scientifico | |
Carattere della pubblicazione: | Scientifica | |
Presenza di un coautore afferente ad Istituzioni straniere: | Si | |
Titolo: | Carotid plaque detection improves the predictve value of CHA2DS2-VASc score in patients with non-valvular atrial fibrilation: The ARAPACIS Study | |
Autori: | Basili, S; Loffredo, L; Pastori, D; Proieti, M; Farcomeni, A; Vesti, A; Pignatelli, P; Davi, G; Hiatt, W; Lip, G; Corazza, G; Perticone, F; Violi, F; Alessandri, C; Serviddio, G; Fascetti, S; Palange, P; Greco, E; Bruno, G; Averna, M; Giammanco, A; Sposito, P; De Cristofaro, R; De Gennaro, L; Carulli, L; Pellegrini, E; Cominacini, L; Mozzini, C; Pasini, A; Sprovieri, M; Spagnuolo, V; Cerqua, G; Cerasola, G; Mule, G; Barbagallo, M; Lo Sciuto, S; Monteverde, A; Saitta, A; Lo Gullo, A; Malatino, L; Ciia, C; Terranova, V; Pisano, M; Pinto, A; Di Raimondo, D; Tuttolomondo, A; Conigliaro, R; Signorelli, S; De Palma, D; Galderisi, M; Cudemo, G; Galletti, F; Fazio, V; De Luca, N; Meccariello, A; Caputo, D; De Donato, M; Iannuzi, A; Bresciani, A; Giunta, R; Utili, R; Iorio, V; Adinolfi, L; Sellitto, C; Iuliano, N; Bellis, P; Tirelli, P; Sacerdoti, D; Vanni, D; Iuliano, L; Ciacciarelli, M; Pacelli, A; Palazzuoli, A; Cacciafesta, M; Gueli, N; Lo Iacono, G; Brusco, S; Verrusio, W; Nobili, L; Tarquinio, N; Pellegrini, F; Vincentelli, G; Ravallese, F; Santini, C; Letizia, C; Petramala, L; Zinnamosca, L; Minisola, S; Cilli, M; Savoriti, C; Colangelo, L; Falaschi, P; Martocchia, A; Pastore, F; Bertazzoni, G; Attalla El Halabieh, E; Paradiso, M; Lizzi, E; Timmi, S; Battisti, P; Cerci, S; Ciavolella, M; Di Veroli, C; Malei, F; De Ciocchis, A; Abate, D; Castellino, P; Zanoli, L; Fidone, F; Mannarino, E; Pasqualini, L; Oliverio, G; Pende, A; Aitom, N; Ricchio, R; Fimognari, F; Alletto, M; Messina, S; Sesti, G; Arturi, F; Fiorentino, T; Pedace, E; Scarpino, P; Carullo, G; Maio, R; Sciacqua, A; Frugiuele, P; Spagnuolo, V; Battaglia, G; Atzori, S; Delitala, G; Angelucci, E; Sestili, S; Traisci, G; De Feudis, L; Di Michele, D; Fava, A; Balsano, C; De Ciantis, P; Desideri, G; Camerota, A; Mezzetti, M; Gresele, P; Vedovati, C; Fierro, T; Puccetti, L; Bertolotti, M; Mussi, C; Boddi, M; Savino, A; Contri, S; Degl'Innocenti, G; Sailer, A; Fabris, F; Pesavento, R; Filippi, L; Vedovetto, V; Puato, M; Fabris, F; Treleani, M; De Luca, E; De Zaiacomo, F; Giantin, V; Semplicini, A; Minuz, P; Romano, S; Fantin, F; Manica, A; Stockner, I; Pattis, P; Gutmann, B; Catena, C; Colussi, G; Sechi, L; Annoni, G; Bruni, A; Castagna, A; Spinelli, D; Miceli, E; Paduia, D; Schinco, G; Spreafico, S; Secchi, B; Vanoli, M; Casella, G; Pulixi, E; Sansone, L; Serra, M; Longo, S; Antonaci, S; Belfiaore, A; Frualdo, M; Palasciano, G; Ricci, L; Ventrella, F; Bianco, C; Santovito, D; Cipollone, F; Nicolai, S; Salvati, F; Rini, G; Scozzari, F; Muiesan, M; Salvetti, M; Bazza, A; Picardi, A; Vespasiani-Gentilucci, U; De Vincentis, A; Cosio, P; Terzolo, M; Madaffari, B; Parasporo, B; Fenoglio, L; Bracco, C; Melchio, R; Gentili, T; Salvi, A; Nitti, C; Gabrielli, A; Martino, G; Capucci, A; Brambatti, M; Sparagna, A; Tirotta, D; Andreozzi, P; Ettorre, E; Viscogliosi, G; Servello, A; Musumeci, M; Rossi Fanelli, F; Delfino, M; Giorgi, A; Glorioso, N; Melis, G; Marras, G; Matta, M; Sacco, A; Stellitano, E; Scordo, A; Russo, F; Caruso, A; Porreca, E; Tana, M; Ferri, C; Cheli, P; Portincasa, P; Muscianisi, G; Giordani, S; Stanghellini, V; Sabba, C; Mancuso, G; Bartone, M; Calipari, D; Arcidiacono, G; Bellanuova, I; Ferraro, M; Marigliano, G; Cozzolino, D; Lampitella, A; Acri, V; Galasso, D; Mazzei, F; Galasso, S; Buratti, A; Porta, M; Brizzi, M; Fattorini, A; Sampietro, F; D'Angelo, A; Manfredini, R; Pala, M; Fabbian, F; Moroni, C; Valente, L; Lopreiato, F; Parente, F; Granata, M; Moia, M; Braham, S; Rossi, M; Pesce, M; Gentile, A; Catozzo, V; Baciarello, G; Cosimati, A; Ageno, W; Rancan, E; Guasti, L; Ciccaglioni, A; Negri, S; Polselli, M; Prisco, D; Marcucci, R; Ferro, D; Cangemi, R; Perri, L; Polimeni, L; Catasca, E; Vicario, T; Russo, R; Saliola, M; Del Ben, M; Ange-lico, F; Calvieri, C; Bucci, T; Baratta, F; Migliacci, R; Porciello, G; Corrao, S; Pignataro, F; Napoleone, L; Talerico, G; Amoroso, D; Romiti, G; Ruscio, E; Toriello, F; Todisco, T; Di Tanna, G; Saccheti, M; Puddu, P; Anzaldi, M; Bazzini, C; Bianchi, P; Boari, B; Bracco, G; Buonauro, A; Butta, C; Buzzetti, E; Calabria, S; Capeci, W; Caradio, F; Carleo, P; Carrabba, M; Castorani, L; Cecchetto, L; Cicco, S; Cimini, C; Colombo, B; De Giorgi, A; De Vuono, S; Del Corso, L; Denegri, A; Di Giosia, P; Durante Mangoni, E; Falsetti, L; Forgione, A; Giorgini, P; Grassi, D; Grembiale, A; Hijazi, D; Iamele, L; Lorusso, G; Marchese, A; Marra, A; Masala, M; Miceli, G; Montebianco Abenavoli, L; Murgia, G; Naccarato, P; Paduia, D; Pattoneri, P; Perego, F; Pesce, P; Piano, S; Pinna, M; Pinto, D; Pretti, V; Pucci, G; Raparelli, V; Salinaro, F; Salzano, A; Santilli, F; Scarpini, F; Scicali, R; Sirico, D; Suppressa, P; Talia, M; Tassone, E; Torres, D; Vazzana, N; Vecchio, C; Vidili, G; Vitale, F; Zaccone, V | |
Autori: | ||
Data di pubblicazione: | 2017 | |
Lingua: | English | |
Rivista: | INTERNATIONAL JOURNAL OF CARDIOLOGY | |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1016/j.ijcard.2017.01.001 | |
Appare nelle tipologie: | 01 - Articolo su rivista |