Comparison of CHA2DS2-VASc, CHADS2 and HATCH scores for the prediction of new-onset atrial fibrillation in cancer patients: A nationwide cohort study of 760,339 study participants with competing risk analysis

Abstract

Background and aims: The current study was conducted to assess the ability of CHA₂DS₂-VASc, CHADS₂ and HATCH scores in predicting new-onset atrial fibrillation (AF) among patients with cancer.

Methods: Patients with newly diagnosed cancer between 1 January, 2000 and 31 December, 2011, from the Registry for Catastrophic Illness Patient Database, were defined as the study cohort. CHA₂DS₂-VASc, CHADS₂ and HATCH scores were used for new-onset AF prediction in these study patients, and the predictive accuracy of the scores was assessed by the receiver operating characteristics (ROC) curve.

Results: A total of 760,339 cancer patients were identified as the study participants. The ROC curves were 0.68 (95% confidence interval [CI] = 0.68-0.69) for the CHA₂DS₂-VASc score, 0.67 (95% CI = 0.67-0.68) for the CHADS₂ score and 0.69 (95% CI = 0.69-0.70) for the HATCH score. There were significant differences of c-statistics among CHA₂DS₂-VASc score, CHADS₂ score and HATCH score (CHA₂DS₂-VASc score vs. CHADS₂ score, p = 0.01; CHA₂DS₂-VASc score vs. HATCH score, p = 0.002; CHADS₂ score vs. HATCH score, p < 0.001).

Conclusions: The current study is the first to assess the prognostic value of 3 AF risk scores (CHA₂DS₂-VASc, CHADS₂ and HATCH scores) in patients with newly-diagnosed cancer. HATCH score was found to have a slightly but significantly better predictive performance than the other 2 scores.

Keywords: Atrial fibrillation; CHA(2)DS(2)-VASc score; CHADS(2) score; Cancer; HATCH score.