scholarly journals Relationship Among Atrial Fibrillation, CHADS2 Score and Ischaemic Stroke in Patients With Coronary Artery Disease: A Propensity Score Matching Study

2020 ◽  
Author(s):  
Boqun Shi ◽  
Demin Liu ◽  
Qian Wang ◽  
Xue Geng ◽  
Qian Hou ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Propensity Score ◽  
Ischaemic Stroke ◽  
Propensity Score Matching ◽  
Stroke Patients ◽  
Stroke Group ◽  
Artery Disease ◽  
The Relationship

Abstract Objective: The purpose of this study was to investigate the relationship among atrial fibrillation (AF), CHADS2 score and ischaemic stroke in patients with coronary artery disease.Methods: A total of 2335 patients with coronary artery disease were included. They were divided into a nonischaemic stroke group (n=1997) and an ischaemic stroke group (n=388). Propensity score matching (PSM) was used to match ischaemic stroke patients with nonischaemic stroke patients in a 1:4 ratio. The relationship between AF, CHADS2 score and ischaemic stroke was evaluated using a univariate generalized linear model in different age, body mass index, and coronary artery disease subgroups. Univariate and multivariate generalized linear models were used to evaluate the relationship between AF and ischaemic stroke in different models.Results: Compared with the nonischaemic stroke group, the rate of AF (8.81% vs. 14.20%, P=0.002) in the ischaemic stroke group was higher. The proportion of patients with ischaemic stroke was significantly different between the AF group and the non-AF group (19.04% vs. 28.74%, P=0.003). With increasing CHADS2 score, the incidence of AF gradually increased (P for trend <0.001). With increasing AF burden, the rate of ischaemic stroke increased continuously (P for trend <0.001). Subgroup analysis showed that the trend towards increased stroke risk in the AF group was consistent across the various subgroups. Multivariate analysis demonstrated that paroxysmal and nonparoxysmal AF were not associated with ischaemic stroke compared with the absence of AF.Conclusion: After adjusting for confounding factors, the correlation between AF and ischaemic stroke decreased. Atherosclerotic factors may play an important role in ischaemic stroke in patients with coronary heart disease.

scholarly journals Comparison of Nearest Neighbor and Caliper Algorithms in Outcome Propensity Score Matching to Study the Relationship between Type 2 Diabetes and Coronary Artery Disease

2021 ◽  
Author(s):  
Sara Sabbaghian Tousi ◽  
Hamed Tabesh ◽  
Azadeh Saki ◽  
Ali Tagipour ◽  
Mohammad Tajfard
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Nearest Neighbor ◽  
Nearest Neighbor Algorithm ◽  
Artery Disease ◽  
The Relationship

Introduction: Propensity score matching (PSM) is a method to reduce the impact of essential and confounders. When the number of confounders is high, there may be a problem of matching, in which, finding matched pairs for the case group is difficult, or impossible. The propensity score (PS) minimizes the effect of the confounders, and it is reduced to one dimension. There are various algorithms in the field of PSM. This study aimed to compared the nearest neighbor and caliper algorithms. Methods: Data obtained in this study were from patients undergoing angiography at Ghaem Hospital in Mashhad, between 2011-12. The study was a retrospective case-control using PSM. In total, 604 patients were included in the case and control groups. A logistic regression model was used to calculate the propensity score and adjust the variables, such as age, gender, Body Mass Index (BMI), systolic blood pressure, smoking status, and triglyceride. Then, the Odds Ratios (ORs) with 95% Confidence Intervals (CIs) for the raw data and two matching algorithms were determined to examine the relationship between type 2 diabetes and coronary artery disease (CAD). Results: Propensity score in the nearest neighbor and caliper algorithms matched the total number of 604 samples, 200 and 178 pairs, respectively. All variables were significantly different between the two groups before matching (P<0.05). The gender was significantly different between the two groups after matching using the nearest neighbor algorithm (P=0.002). No variables created a significant difference between the two groups after matching with the caliper algorithm. Conclusion: Bias reduction in the caliper algorithm was greater than for the nearest neighbor algorithm for all variables except the triglyceride variable.

Should the Presence or Extent of Coronary Artery Disease be Quantified in the CHA2DS2-VASc Score in Atrial Fibrillation? A Report from the Western Denmark Heart Registry

2018 ◽  
Vol 118 (12) ◽  
pp. 2162-2170 ◽  
Author(s):  
Kamilla Steensig ◽  
Kevin Olesen ◽  
Troels Thim ◽  
Jens Nielsen ◽  
Svend Jensen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Ischaemic Stroke ◽  
Independent Risk Factor ◽  
Oral Anticoagulants ◽  
Increased Risk ◽  
Artery Disease

Background Patients with atrial fibrillation (AF) have an increased risk of ischaemic stroke. The risk can be predicted by the CHA2DS2-VASc score, in which the vascular component refers to previous myocardial infarction, peripheral artery disease and aortic plaque, whereas coronary artery disease (CAD) is not included. Objectives This article explores whether CAD per se or extent provides independent prognostic information of future stroke among patients with AF. Materials and Methods Consecutive patients with AF and coronary angiography performed between 2004 and 2012 were included. The endpoint was a composite of ischaemic stroke, transient ischaemic attack and systemic embolism. The risk of ischaemic events was estimated according to the presence and extent of CAD. Incidence rate ratios (IRR) were calculated in reference to patients without CAD and adjusted for parameters included in the CHA2DS2-VASc score and treatment with anti-platelet agents and/or oral anticoagulants. Results Of 96,430 patients undergoing coronary angiography, 12,690 had AF. Among patients with AF, 7,533 (59.4%) had CAD. Mean follow-up was 3 years. While presence of CAD was an independent risk factor for the composite endpoint (adjusted IRR, 1.25; 1.06–1.47), extent of CAD defined as 1-, 2-, 3- or diffuse vessel disease did not add additional independent risk information. Conclusion Presence, but not extent, of CAD was an independent risk factor of the composite thromboembolic endpoint beyond the components already included in the CHA2DS2-VASc score. Consequently, we suggest that significant angiographically proven CAD should be included in the vascular disease criterion in the CHA2DS2-VASc score.

Impact of Pre-Existing Depression in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention; A Nationwide Cohort Study

2020 ◽  
Author(s):  
Jangho Park ◽  
Sangwoo Park ◽  
Yong-Giun Kim ◽  
Soe Hee Ann ◽  
Hyun Woo Park ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Artery Disease ◽  
The Impact

Abstract The impact of pre-existing depression on mortality in individuals with established coronary artery disease (CAD) remains unclear. We evaluate the clinical implications of pre-existing depression in patients who underwent percutaneous coronary intervention (PCI). Based on National Health Insurance claims data in Korea, patients without a known history of CAD who underwent PCI between 2013 and 2017 were enrolled. The study population was divided into patients with angina (n=50,256) or acute myocardial infarction (AMI; n=40,049). The primary endpoint, defined as all-cause death, was compared between the non-depression and depression groups using propensity score matching analysis. After propensity score matching, there were 4,262 and 2,346 matched pairs of patients with angina and AMI, respectively. During the follow-up period, there was no significant difference in the incidence of all-cause death in the angina (hazard ratio [HR] of depression, 1.013; 95% confidence interval [CI]: 0.893-1.151) and AMI (HR, 0.991; 95% CI: 0.865-1.136) groups. However, angina patients less than 65 years of age with depression had higher all-cause mortality (HR, 1.769; 95% CI: 1.240-2.525). In Korean patients undergoing PCI, pre-existing depression is not associated with poorer clinical outcomes. However, in younger patients with angina, depression is associated with higher all-cause mortality.

scholarly journals Relationship among atrial fibrillation, the CHA2DS2-VASc score and ischaemic stroke in patients with coronary artery disease: a propensity score matching study in Hebei, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Boqun Shi ◽  
Demin Liu ◽  
Qian Wang ◽  
Xue Geng ◽  
Qian Hou ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Generalized Linear Models ◽  
Linear Models ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Stroke Group ◽  
Artery Disease ◽  
The Relationship

Abstract Background Recent evidence has shown that the pathogenesis of ischaemic stroke associated with atrial fibrillation (AF) is complex and involves other factors in addition to arrhythmias. The purpose of this study was to investigate the relationship among AF, CHA2DS2-VASc score and ischaemic stroke in patients with coronary artery disease (CAD) in Hebei, China. Methods A total of 2,335 patients with CAD from September 2016 to May 2019 at the Second Hospital of Hebei Medical University were included (mean age 62.73 ± 10.35 years, range 26–92 years; 41.58% female). This was a cross-sectional study, and participants were divided into non-stroke (n = 1997) and ischaemic stroke groups (n = 338). Propensity score matching (PSM) was performed to match ischaemic stroke patients with non-stroke patients in a 1:4 ratio. The relationship among AF, the CHA2DS2-VASc score and ischaemic stroke was evaluated using univariable generalized linear models for different sex, age, body mass index (BMI), CAD and CHA2DS2-VASc score subgroups. Univariable and multivariable generalized linear models were used to evaluate the relationship between AF and ischaemic stroke in the different models. Results Compared with that in the non-stroke group, the prevalence of AF (8.81% vs. 14.20%, P = 0.002) in the ischaemic stroke group was higher. The proportion of patients with ischaemic stroke was significantly different between the AF group and the non-AF group (28.74% vs. 19.04%, P = 0.003). An increasing CHA2DS2-VASc score was associated with a gradual increase in the prevalence of AF (P for trend < 0.001). Subgroup analysis showed that the trend towards increased stroke risk in the AF group was consistent across the various subgroups. The multivariable analysis demonstrated that AF was not associated with ischaemic stroke compared with the absence of AF (OR = 1.55, 95% CI 0.94–2.56, P = 0.087). Conclusion In our cross-sectional study, after adjustment for confounding factors, there was no association between AF and ischaemic stroke. The increased risk of ischaemic stroke associated with AF was attenuated by atherosclerotic factors. Our study supports the current view that enhanced control of modifiable cardiovascular risk factors in patients with AF is essential.

scholarly journals Pre-existing depression in patients with coronary artery disease undergoing percutaneous coronary intervention

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jangho Park ◽  
Sangwoo Park ◽  
Yong-Giun Kim ◽  
Soe Hee Ann ◽  
Hyun Woo Park ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Artery Disease ◽  
The Impact

AbstractThe impact of pre-existing depression on mortality in individuals with established coronary artery disease (CAD) remains unclear. We evaluate the clinical implications of pre-existing depression in patients who underwent percutaneous coronary intervention (PCI). Based on National Health Insurance claims data in Korea, patients without a known history of CAD who underwent PCI between 2013 and 2017 were enrolled. The study population was divided into patients with angina (n = 50,256) or acute myocardial infarction (AMI; n = 40,049). The primary endpoint, defined as all-cause death, was compared between the non-depression and depression groups using propensity score matching analysis. After propensity score matching, there were 4262 and 2346 matched pairs of patients with angina and AMI, respectively. During the follow-up period, there was no significant difference in the incidence of all-cause death in the angina (hazard ratio [HR] of depression, 1.013; 95% confidence interval [CI] 0.893–1.151) and AMI (HR, 0.991; 95% CI 0.865–1.136) groups. However, angina patients less than 65 years of age with depression had higher all-cause mortality (HR, 1.769; 95% CI 1.240–2.525). In Korean patients undergoing PCI, pre-existing depression is not associated with poorer clinical outcomes. However, in younger patients with angina, depression is associated with higher all-cause mortality.

Coronary collateral function in the transplanted heart: propensity score matching with coronary artery disease

Heart ◽  
2011 ◽  
Vol 97 (7) ◽  
pp. 557-563 ◽  
Author(s):  
T. Rutz ◽  
S. Gloekler ◽  
S. F. de Marchi ◽  
T. Traupe ◽  
P. Meier ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Coronary Collateral ◽  
Artery Disease
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