SCORE2 and SCORE2-OP Assessment in the Predicting of Cardiovascular Diseases and AF Recurrence in Hypertensive AF Patients Who Underwent Catheter Ablation.
Gülhan Yüksel, Mustafa Lütfullah Ardıç, Hilmi Erdem Sumbul, Mevlut Koc
Abstract
Open AccessBackground/aims: Hypertension (HT) is a modifiable risk factor for the development of cardiovascular disease (CVD) in patients with atrial fibrillation (AF). There are no data on the use of the SCORE2 and SCORE2-OP risk scores used in patients with AF. In our study, we aimed to determine the effect of SCORE2 and SCORE2-OP risk scores on AF recurrence and CVD development after catheter ablation (CA) in AF patients with HT. Methods: This retrospective cohort study included 266 patients (144 men, 122 women, 57.1 ± 11 years) who underwent CA with a diagnosis of paroxysmal AF. Patients were grouped as <5%-5% to <10%-≥10% (Group I-II-III, respectively) according to CVD risk in SCORE2 and SCORE2-OP. The primary endpoint was adverse CVD. The secondary endpoint was AF recurrence. Results: The frequency of CVD and AF recurrence in groups I-II-III was 0(0%)-8(8%)-14(15%) and 9(13%)-17(16%)-23(25%), respectively (p = 0.001 and p = 0.035). Age, systolic blood pressure, presence of CVD risk ≥ 10%, CHA2DS2-VA, BUN, and uric acid were found to be higher in those with CVD. In logistic regression analysis, the presence of CVD risk ≥ 10%, CHA2DS2-VA and uric acid were found to independently predict the development of CVD (OR = 3.960, 95%CI-1.098-8.508, p = 0.019, OR = 3.257, 95%CI-1.067-7.318, p = 0.015 and OR = 1.967, 95%CI-1.359-2.873, p = 0.001). Triglycerides, CVD risk of ≥10%, and left atrial end-diastolic diameter (LAd) were found to be higher in those with AF recurrence. In regression analysis, the presence of CVD risk ≥ 10% and LAd were found to independently determine the development of AF recurrence (OR = 2.448, 95%CI-0.993-1.023, p = 0.005, OR = 1.217, 95%CI-1.124-1.319). Conclusions: SCORE2 and SCORE2-OP algorithms performed before the procedure in isolated HT patients undergoing ablation for paroxysmal AF can be used to predict AF recurrence and CVD development. The SCORE2 and SCORE2-OP algorithms have been evaluated exclusively in patients with isolated hypertension; therefore, further studies are needed to determine their applicability in the broader atrial fibrillation population.