A Newly Defined CHA₂DS₂-VA Score for Predicting Obstructive Coronary Artery Disease in Patients with Atrial Fibrillation—A Cross-Sectional Study of Older Persons Referred for Elective Coronary Angiography

Abstract

Purpose: Atrial fibrillation (AF) can be a valuable indicator of non-obstructive coronary artery disease (CAD) among older patients indicated for elective coronary angiography (CAG). Appropriate stratification of AF patients is crucial for avoiding unnecessary complications. The objective of this study was to identify independent predictors that can allow diagnosing obstructive CAD in AF patients over 65 years who were indicated to undergo elective CAG. Patients and methods: This cross-sectional study included 452 (23.9%) AF patients over 65 years old who were directed to the Department of Invasive Cardiology at the Medical University of Bialystok for elective CAG during 2014–2016. The participants had CAD and were receiving optimal therapy (median age: 73 years, interquartile range: 69–77 years; 54.6% men). The prevalence and health correlates of obstructive CAD were determined, and a multivariate logistic regression model was generated with predictors (p p = 0.01) and the newly created CHA2DS2-VA score (OR: 3.96, 95% CI: 2.96–5.31, p 2DS2-VA scale may be a useful screening tool for the diagnosis of obstructive CAD (area under the ROC curve: 0.79, 95% CI: 0.75–0.84, p 2DS2-VA score can contribute to improving the selection of patients for invasive diagnosis of CAD, but further investigation is required.

Keywords

• obstructive coronary lesions
• geriatric patients
• predictive factors
• chronic coronary artery disease