Abstract
Background: The TIMI-AF score predicts poor outcomes in patients with atrial fibrillation (AF) and guides selection of anticoagulant therapy by identifying clinical benefit of direct oral anticoagulants (DOACs) or vitamin K antagonists (VKA). Hypothesis: Our objective was to determine the ability to predict cardiovascular events according to the TIMI-AF score in a real-world population. Methods: Retrospective observational study of VKA-naïve patients with AF was seen at a cardiology outpatient clinic in Spain between November 2012 and August 2014. We recorded adverse events (myocardial infarction, systemic embolism or stroke, major bleeding, and death). Results: The study population comprised of 426 patients (50.7% men, mean age, 69 ± 14 years). The TIMI-AF score identified 372 patients (87.3%) with a low risk, 50 patients (11.7%) with an intermediate risk, and 4 patients (0.9%) with a high risk. After a mean follow-up of 423.4 ± 200.1 days, 37 patients (9%) experienced an adverse event. Patients with a TIMI-AF score ≥ 7 had a poorer cardiovascular prognosis (HR, 6.1; 95%CI, 3.2-11.7; P < 0.001). The area under the ROC curve of TIMI-AF was 0.755 (95%CI, 0.669-0.840; P < 0.001), which was greater than that of CHA2DS2VASc (0.641; 95%CI, 0.559-0.724; P = 0.004), HAS-BLED (0.666; 95%CI, 0.578-0.755; P < 0.001), and SAMeTT2R2 (0.529; 95%CI, 0.422-0.636; P = 0.565). Similar results were obtained in relation to the net clinical outcome (life-threatening bleeding, disabling stroke, or all-cause mortality). Conclusions: The TIMI-AF risk score can identify patients who are at greater risk of cardiovascular events and a poor net clinical outcome with a better diagnostic yield than CHA2DS2VASc, HAS-BLED, and SAMeTT2R2.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1252-1258 |
| Number of pages | 7 |
| Journal | Clinical Cardiology |
| Volume | 41 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 1 2018 |
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Keywords
- TIMI-AF score
- anticoagulants
- atrial fibrillation
- cardiovascular prognosis
PubMed: MeSH publication types
- Journal Article
- Observational Study
Cite this
TIMI-AF score and cardiovascular events in vitamin K antagonists-naïve outpatients with atrial fibrillation. / Pérez Cabeza, Alejandro Isidoro; Bravo Marques, Rafael; Chinchurreta Capote, Pedro Antonio; Ruiz Mateas, Francisco; Fanola, Christina; Rosas Cervantes, Gabriel; González Correa, Jose Antonio; Valle Alberca, Almudena; Mesa Prado, Fidel; López Tejero, Sergio; Ruff, Christian Thomas.
In: Clinical Cardiology, Vol. 41, No. 9, 01.09.2018, p. 1252-1258.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - TIMI-AF score and cardiovascular events in vitamin K antagonists-naïve outpatients with atrial fibrillation
AU - Pérez Cabeza, Alejandro Isidoro
AU - Bravo Marques, Rafael
AU - Chinchurreta Capote, Pedro Antonio
AU - Ruiz Mateas, Francisco
AU - Fanola, Christina
AU - Rosas Cervantes, Gabriel
AU - González Correa, Jose Antonio
AU - Valle Alberca, Almudena
AU - Mesa Prado, Fidel
AU - López Tejero, Sergio
AU - Ruff, Christian Thomas
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Background: The TIMI-AF score predicts poor outcomes in patients with atrial fibrillation (AF) and guides selection of anticoagulant therapy by identifying clinical benefit of direct oral anticoagulants (DOACs) or vitamin K antagonists (VKA). Hypothesis: Our objective was to determine the ability to predict cardiovascular events according to the TIMI-AF score in a real-world population. Methods: Retrospective observational study of VKA-naïve patients with AF was seen at a cardiology outpatient clinic in Spain between November 2012 and August 2014. We recorded adverse events (myocardial infarction, systemic embolism or stroke, major bleeding, and death). Results: The study population comprised of 426 patients (50.7% men, mean age, 69 ± 14 years). The TIMI-AF score identified 372 patients (87.3%) with a low risk, 50 patients (11.7%) with an intermediate risk, and 4 patients (0.9%) with a high risk. After a mean follow-up of 423.4 ± 200.1 days, 37 patients (9%) experienced an adverse event. Patients with a TIMI-AF score ≥ 7 had a poorer cardiovascular prognosis (HR, 6.1; 95%CI, 3.2-11.7; P < 0.001). The area under the ROC curve of TIMI-AF was 0.755 (95%CI, 0.669-0.840; P < 0.001), which was greater than that of CHA2DS2VASc (0.641; 95%CI, 0.559-0.724; P = 0.004), HAS-BLED (0.666; 95%CI, 0.578-0.755; P < 0.001), and SAMeTT2R2 (0.529; 95%CI, 0.422-0.636; P = 0.565). Similar results were obtained in relation to the net clinical outcome (life-threatening bleeding, disabling stroke, or all-cause mortality). Conclusions: The TIMI-AF risk score can identify patients who are at greater risk of cardiovascular events and a poor net clinical outcome with a better diagnostic yield than CHA2DS2VASc, HAS-BLED, and SAMeTT2R2.
AB - Background: The TIMI-AF score predicts poor outcomes in patients with atrial fibrillation (AF) and guides selection of anticoagulant therapy by identifying clinical benefit of direct oral anticoagulants (DOACs) or vitamin K antagonists (VKA). Hypothesis: Our objective was to determine the ability to predict cardiovascular events according to the TIMI-AF score in a real-world population. Methods: Retrospective observational study of VKA-naïve patients with AF was seen at a cardiology outpatient clinic in Spain between November 2012 and August 2014. We recorded adverse events (myocardial infarction, systemic embolism or stroke, major bleeding, and death). Results: The study population comprised of 426 patients (50.7% men, mean age, 69 ± 14 years). The TIMI-AF score identified 372 patients (87.3%) with a low risk, 50 patients (11.7%) with an intermediate risk, and 4 patients (0.9%) with a high risk. After a mean follow-up of 423.4 ± 200.1 days, 37 patients (9%) experienced an adverse event. Patients with a TIMI-AF score ≥ 7 had a poorer cardiovascular prognosis (HR, 6.1; 95%CI, 3.2-11.7; P < 0.001). The area under the ROC curve of TIMI-AF was 0.755 (95%CI, 0.669-0.840; P < 0.001), which was greater than that of CHA2DS2VASc (0.641; 95%CI, 0.559-0.724; P = 0.004), HAS-BLED (0.666; 95%CI, 0.578-0.755; P < 0.001), and SAMeTT2R2 (0.529; 95%CI, 0.422-0.636; P = 0.565). Similar results were obtained in relation to the net clinical outcome (life-threatening bleeding, disabling stroke, or all-cause mortality). Conclusions: The TIMI-AF risk score can identify patients who are at greater risk of cardiovascular events and a poor net clinical outcome with a better diagnostic yield than CHA2DS2VASc, HAS-BLED, and SAMeTT2R2.
KW - TIMI-AF score
KW - anticoagulants
KW - atrial fibrillation
KW - cardiovascular prognosis
UR - http://www.scopus.com/inward/record.url?scp=85053191324&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053191324&partnerID=8YFLogxK
U2 - 10.1002/clc.23035
DO - 10.1002/clc.23035
M3 - Article
VL - 41
SP - 1252
EP - 1258
JO - Clinical Cardiology
JF - Clinical Cardiology
SN - 0160-9289
IS - 9
ER -