+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

The predictive value of CHADS₂ risk score in post myocardial infarction arrhythmias - a Cardiac Arrhythmias and RIsk Stratification after Myocardial infArction (CARISMA) substudy

The predictive value of CHADS₂ risk score in post myocardial infarction arrhythmias - a Cardiac Arrhythmias and RIsk Stratification after Myocardial infArction (CARISMA) substudy

International Journal of Cardiology 173(3): 441-446

Previous studies have shown substantially increased risk of cardiac arrhythmias and sudden cardiac death in post-myocardial infarction (MI) patients. However it remains difficult to identify the patients who are at highest risk of arrhythmias in the post-MI setting. The purpose of this study was to investigate if CHADS₂ score (congestive heart failure, hypertension, age ≥75 years, diabetes and previous stroke/TCI [doubled]) can be used as a risk tool for predicting cardiac arrhythmias after MI. The study included 297 post-MI patients from the CARISMA study with left ventricular ejection fraction (LVEF) ≤40%. All patients were implanted with an implantable cardiac monitor (ICM) within 5 to 21 days post-MI and followed every three months for two years. Atrial fibrillation, bradyarrhythmias and ventricular tachycardias were diagnosed using the ICM, pacemaker or ICD. Patients were stratified according to CHADS₂ score at enrollment. Congestive heart failure was defined as LVEF ≤40% and NYHA class II, III or IV. We found significantly increased risk of an arrhythmic event with increasing CHADS₂ score (CHADS₂ score=1-2: HR=2.1 [1.1-3.9], p=0.021, CHADS₂ score ≥ 3: HR=3.7 [1.9-7.1], p<0.001). This pattern was identical when dividing the arrhythmias into subgroups of atrial fibrillation, ventricular tachycardias and bradyarrhythmias. CHADS₂ score was similarly associated with the development of major cardiovascular events defined as reinfarction, stroke, and hospitalization for heart failure or cardiovascular death. In the post-MI setting, CHADS₂ score efficiently identifies populations at high risk for cardiac arrhythmias.

(PDF emailed within 0-6 h: $19.90)

Accession: 056439857

Download citation: RISBibTeXText

PMID: 24713455

DOI: 10.1016/j.ijcard.2014.03.010

Related references

New-onset atrial fibrillation predicts malignant arrhythmias in post-myocardial infarction patients--a Cardiac Arrhythmias and RIsk Stratification after acute Myocardial infarction (CARISMA) substudy. American Heart Journal 166(5): 855-63.E3, 2014

Clinical significance of late high-degree atrioventricular block in patients with left ventricular dysfunction after an acute myocardial infarction--a Cardiac Arrhythmias and Risk Stratification After Acute Myocardial Infarction (CARISMA) substudy. American Heart Journal 162(3): 542-547, 2011

Long-term recording of cardiac arrhythmias with an implantable cardiac monitor in patients with reduced ejection fraction after acute myocardial infarction: the Cardiac Arrhythmias and Risk Stratification After Acute Myocardial Infarction (CARISMA) study. Circulation 122(13): 1258-1264, 2010

Cardiac arrhythmias and risk stratification after myocardial infarction: results of the CARISMA pilot study. Pacing and Clinical Electrophysiology 26(1 Pt 2): 416-419, 2003

Additional predictive value of serum potassium to Thrombolysis In Myocardial Infarction risk score for early malignant ventricular arrhythmias in patients with acute myocardial infarction. American Journal of Emergency Medicine 30(7): 1089-1094, 2012

Cardiac arrhythmias and risk stratification after myocardial infarction Results of the pilot Study. European Heart Journal 23(Abstract Supplement): 410, August-September, 2002

Absence of slowest oscillations in short term heart rate variability of post-myocardial infarction patients. GISSI-3 arrhythmias substudy. GISSI-3 Arrhythmias Substudy Investigators. Autonomic Neuroscience 90(1-2): 127-131, 2001

Cardiac magnetic resonance image-based classification of the risk of arrhythmias in post-myocardial infarction patients. Artificial Intelligence in Medicine 64(3): 205-215, 2016

Sudden death and ventricular arrhythmias risk stratification after myocardial infarction. Revista Medico-Chirurgicala a Societatii de Medici Si Naturalisti Din Iasi 114(1): 13-19, 2010

Risk stratification for malignant arrhythmias after myocardial infarction. A reappraisal in the era of thrombolysis. Archivos del Instituto de Cardiologia de Mexico 67(3): 183-185, 1997

Risk stratification after myocardial infarction: a new method of determining the neural component of the baroreflex is potentially more discriminative in distinguishing patients at high and low risk for arrhythmias. Europace 10(2): 227-234, 2008

Risk stratification after myocardial infarction. Different methods for the prediction of life-threatening arrhythmias. Deutsche Medizinische Wochenschrift 123(42): 1250-1257, 1998

Prediction of life-threatening arrhythmias: Multifactorial risk stratification following acute myocardial infarction. International Journal of Angiology 6(4): 241-253, 1997

At-admission risk stratification for in-hospital life-threatening ventricular arrhythmias and death in non-ST elevation myocardial infarction patients. European Heart Journal. Acute Cardiovascular Care 3(4): 304-312, 2015

The MI SYNTAX score for risk stratification in patients undergoing primary percutaneous coronary intervention for treatment of acute myocardial infarction: a substudy of the COMFORTABLE AMI trial. International Journal of Cardiology 175(2): 314-322, 2015