Usefulness of the CHADS2 Score for Determining Risk of Seizure in Patients With Atrial Fibrillation - 22/10/16
, Jaw-Wen Chen, MD a, e, j, k, Shing-Jong Lin, MD, PhD a, b, c, d, e, jAbstract |
Atrial fibrillation (AF) secondary to seizure has been described in case reports, but the association between AF and risk of seizure has never been evaluated in longitudinal studies. The objectives of this study were to investigate the role of AF on the risk of development of seizure and the usefulness of CHADS2 score for predicting the risk of seizure. Our analyses were conducted using information from a random sample of 1 million subjects enrolled in Taiwan National Health Insurance Research Database. A total of 11,552 subjects aged ≥18 years, comprising 5,776 subjects diagnosed with AF during the study period and 5,776 age and sex-matched subjects without AF were enrolled in our study. During the mean follow-up of 6.7 ± 3.3 years, seizure events occurred in 235 patients. In comparison, the AF group had a higher incidence rate of seizure occurrence (4.17 vs 1.90 per 1,000 person-years). Cox proportional hazard regression model analysis showed that development of AF was independently associated with a higher risk of developing future seizure (adjusted HR 2.30; 95% confidence interval 1.73 to 3.05). In multivariate Cox regression analysis adjusted for potentially confounding variables, a higher CHADS2 score was associated with a higher risk of seizure in a dose-dependent manner. AF may cause an ischemic stroke that subsequently leads to seizure, and present study further demonstrates that AF patients are associated with higher rate of subsequent seizure, even after adjusting for stroke. The CHADS2 score was found to be a useful scheme for predicting the risk of seizure occurrence.
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| Drs Hsu and Chen contributed equally to this work. |
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| Contributions: Research idea and study design: Drs Hsu and Chen; data acquisition: Chang, Su, and Chen; data analysis/interpretation: Drs Hsu, Chen, and Huang; statistical analysis: Drs Hsu, Chen, and Leu; supervision or mentorship: Drs Huang, Chen, and Lin. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved. Dr. Huang takes responsibility that this study has been reported honestly, accurately, and transparently; that no important aspects of the study have been omitted and that any discrepancies from the study as planned (and, if relevant, registered) have been explained. |
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| This study was supported, in part, by the following research grants: Novel Bioengineering and Technological Approaches to Solve Two Major Health Problems in Taiwan sponsored by the Taiwan Ministry of Science and Technology Academic Excellence Program (Taipei, Taiwan) under grant number: MOST 105-2633-B-009-003; V103A-009 from Taipei Veterans General Hospital, Taipei, Taiwan; a grant from the Ministry of Health and Welfare, Taiwan (MOHW 104-TDU-B-211-113-003). Funding agencies had no role in study design, data collection, analysis, decision to publish, or preparation of the manuscript. |
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| See page 1344 for disclosure information. |
Vol 118 - N° 9
P. 1340-1344 - novembre 2016 Retour au numéro
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