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. 2024 Jan;57(1):39-49.
doi: 10.1007/s11239-023-02866-y. Epub 2023 Aug 11.

Validating the predictive ability of the 2MACE score for major adverse cardiovascular events in patients with atrial fibrillation: results from phase II/III of the GLORIA-AF registry

Wern Yew Ding  1 , Ameenathul Mazaya Fawzy  1 , Giulio Francesco Romiti  1   2 , Marco Proietti  1   3   4 , Daniele Pastori  1   5 , Menno V Huisman #  6 , Gregory Y H Lip #  7   8 ; GLORIA-AF Investigators
Collaborators, Affiliations

Validating the predictive ability of the 2MACE score for major adverse cardiovascular events in patients with atrial fibrillation: results from phase II/III of the GLORIA-AF registry

Wern Yew Ding et al. J Thromb Thrombolysis. 2024 Jan.

Erratum in

Abstract

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.

Keywords: Atrial fibrillation; Cardiovascular mortality; Myocardial infarction; Risk stratification.

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Conflict of interest statement

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.

Figures

Fig. 1
Fig. 1
Receiver-operating characteristic curves comparison for major adverse cardiovascular events (MACE) with the 2MACE and CHA2DS2-VASc score
Fig. 2
Fig. 2
Results of the 2MACE score for prediction of MACE in subgroups of patients equal of greater than 75 years, female sex and patients with prior stroke
See this image and copyright information in PMC

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