TY - JOUR
T1 - Validating the predictive ability of the 2MACE score for major adverse cardiovascular events in patients with atrial fibrillation
T2 - results from phase II/III of the GLORIA-AF registry
AU - Ding, Wern Yew
AU - Fawzy, Ameenathul Mazaya
AU - Romiti, Giulio Francesco
AU - Proietti, Marco
AU - Pastori, Daniele
AU - Huisman, Menno V.
AU - Lip, Gregory Y. H.
AU - on behalf of the GLORIA-AF Investigators
AU - Abban, Dzifa Wosornu
AU - Abdul, Nasser
AU - Abud, Atilio Marcelo
AU - Adams, Fran
AU - Addala, Srinivas
AU - Adragão, Pedro
AU - Ageno, Walter
AU - Aggarwal, Rajesh
AU - Agosti, Sergio
AU - Agostoni, Piergiuseppe
AU - Aguilar, Francisco
AU - Linares, Julio Aguilar
AU - Aguinaga, Luis
AU - Ahmed, Jameel
AU - Aiello, Allessandro
AU - Ainsworth, Paul
AU - Aiub, Jorge Roberto
AU - Al-Dallow, Raed
AU - Alderson, Lisa
AU - Velasco, Jorge Antonio Aldrete
AU - Alexopoulos, Dimitrios
AU - Manterola, Fernando Alfonso
AU - Aliyar, Pareed
AU - Alonso, David
AU - da Costa, Fernando Augusto Alves
AU - Amado, José
AU - Amara, Walid
AU - Amelot, Mathieu
AU - Amjadi, Nima
AU - Ammirati, Fabrizio
AU - Andrade, Marianna
AU - Andrawis, Nabil
AU - Annoni, Giorgio
AU - Ansalone, Gerardo
AU - Ariani, M. Kevin
AU - Arias, Juan Carlos
AU - Armero, S. bastien
AU - Arora, Chander
AU - Aslam, Muhammad Shakil
AU - Asselman, M.
AU - Audouin, Philippe
AU - Aydin, S.
AU - de Groot, J. R.
N1 - Funding Information: The GLORIA-AF registry was sponsored by Boehringer Ingelheim GmbH. The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the manuscript, and its final contents. Funding Information: MVH: Research grants from Dutch Healthcare Fund, Dutch Heart Foundation, Bayer Health Care, Pfizer-BMS, Leo Pharma, and consulting fees from Boehringer Ingelheim, Bayer Health Care, Pfizer-BMS. GYHL: Consultant and speaker for BMS/Pfizer, Boehringer Ingelheim and Daiichi-Sankyo. No fees are received personally. Other authors declare no conflict of interest. Publisher Copyright: © 2023, The Author(s).
PY - 2023
Y1 - 2023
N2 - The 2MACE score was specifically developed as a risk-stratification tool in atrial fibrillation (AF) to predict cardiovascular outcomes. We evaluated the predictive ability of the 2MACE score in the GLORIA-AF registry. All eligible patients from phase II/III of the prospective global GLORIA-AF registry were included. Major adverse cardiac events (MACEs) were defined as the composite outcome of stroke, myocardial infarction and cardiovascular death. Cox proportional hazards were used to examine the relationship between the 2MACE score and study outcomes. Predictive capability of the 2MACE score was investigated using receiver-operating characteristic curves. A total of 25,696 patients were included (mean age 71 years, female 44.9%). Over 3 years, 1583 MACEs were recorded. Patients who had MACE were older, with more cardiovascular risk factors and were less likely to be managed using a rhythm-control strategy. The median 2MACE score in the MACE and non-MACE groups were 2 (IQR 1–3) and 1 (IQR 0–2), respectively (p < 0.001). The 2MACE score was positively associated with an increase in the risk of MACE, with a score of ≥ 2 providing the best combination of sensitivity (69.6%) and specificity (51.6%), HR 2.47 (95% CI, 2.21–2.77). The 2MACE score had modest predictive performance for MACE in patients with AF (AUC 0.655 (95% CI, 0.641–0.669)). Our analysis in this prospective global registry demonstrates that the 2MACE score can adequately predict the risk of MACE (defined as myocardial infarction, CV death and stroke) in patients with AF. Clinical trial registration: http://www.clinicaltrials.gov . Unique identifiers: NCT01468701, NCT01671007 and NCT01937377.
AB - The 2MACE score was specifically developed as a risk-stratification tool in atrial fibrillation (AF) to predict cardiovascular outcomes. We evaluated the predictive ability of the 2MACE score in the GLORIA-AF registry. All eligible patients from phase II/III of the prospective global GLORIA-AF registry were included. Major adverse cardiac events (MACEs) were defined as the composite outcome of stroke, myocardial infarction and cardiovascular death. Cox proportional hazards were used to examine the relationship between the 2MACE score and study outcomes. Predictive capability of the 2MACE score was investigated using receiver-operating characteristic curves. A total of 25,696 patients were included (mean age 71 years, female 44.9%). Over 3 years, 1583 MACEs were recorded. Patients who had MACE were older, with more cardiovascular risk factors and were less likely to be managed using a rhythm-control strategy. The median 2MACE score in the MACE and non-MACE groups were 2 (IQR 1–3) and 1 (IQR 0–2), respectively (p < 0.001). The 2MACE score was positively associated with an increase in the risk of MACE, with a score of ≥ 2 providing the best combination of sensitivity (69.6%) and specificity (51.6%), HR 2.47 (95% CI, 2.21–2.77). The 2MACE score had modest predictive performance for MACE in patients with AF (AUC 0.655 (95% CI, 0.641–0.669)). Our analysis in this prospective global registry demonstrates that the 2MACE score can adequately predict the risk of MACE (defined as myocardial infarction, CV death and stroke) in patients with AF. Clinical trial registration: http://www.clinicaltrials.gov . Unique identifiers: NCT01468701, NCT01671007 and NCT01937377.
KW - Atrial fibrillation
KW - Cardiovascular mortality
KW - Myocardial infarction
KW - Risk stratification
UR - http://www.scopus.com/inward/record.url?scp=85168278767&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s11239-023-02866-y
DO - https://doi.org/10.1007/s11239-023-02866-y
M3 - Article
C2 - 37566295
SN - 0929-5305
JO - Journal of Thrombosis and Thrombolysis
JF - Journal of Thrombosis and Thrombolysis
ER -