Predicting arrhythmic event score in Brugada syndrome: Worldwide pooled analysis with internal and external validation
4
Issued Date
2023-01-01
Resource Type
ISSN
15475271
eISSN
15563871
Scopus ID
2-s2.0-85165672314
Pubmed ID
37355026
Journal Title
Heart Rhythm
Rights Holder(s)
SCOPUS
Bibliographic Citation
Heart Rhythm (2023)
Suggested Citation
Rattanawong P., Mattanapojanat N., Mead-Harvey C., Van Der Walt C., Kewcharoen J., Kanitsoraphan C., Vutthikraivit W., Prasitlumkum N., Putthapiban P., Chintanavilas K., Sahasthas D., Ngarmukos T., Thakkinstian A., Sorajja D., Makarawate P., Shen W.K. Predicting arrhythmic event score in Brugada syndrome: Worldwide pooled analysis with internal and external validation. Heart Rhythm (2023). doi:10.1016/j.hrthm.2023.06.013 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/88196
Title
Predicting arrhythmic event score in Brugada syndrome: Worldwide pooled analysis with internal and external validation
Author's Affiliation
Ramathibodi Hospital
Loma Linda University
University of California, Riverside
Mayo Clinic Scottsdale-Phoenix, Arizona
Faculty of Medicine, Khon Kaen University
University of Iowa
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Thammasat University
John H. Stroger, Jr. Hospital of Cook County
Loma Linda University
University of California, Riverside
Mayo Clinic Scottsdale-Phoenix, Arizona
Faculty of Medicine, Khon Kaen University
University of Iowa
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Thammasat University
John H. Stroger, Jr. Hospital of Cook County
Other Contributor(s)
Abstract
Background: Brugada syndrome is an inherited arrhythmic disease associated with major arrhythmic events (MAE). Risk predictive scores were previously developed with various performances. Objective: The purpose of this study was to create a novel score—Predicting Arrhythmic evenT (PAT)—with internal and external validation. Methods: A systematic review was performed to identify risk factors for MAE. The odds ratios (ORs) of each factor were pooled across studies. The PAT scoring scheme was developed based on pooled ORs. The PAT score was internally validated with published 105 Asian patients (follow-up 8.0 ± 4.1 [SD] years) and externally validated with unpublished 164 multiracial patients (82.3% White, 14.6% Asian, 3.2% Black; mean follow-up 8.0 ± 6.9 years) with Brugada syndrome. Performances were assessed and compared with previous scores using receiver operating characteristic curve (ROC) analysis. Results: Sixty-seven studies published between 2002 and 2022 from 26 countries (7358 patients) were included. Pooled ORs were estimated, indicating that 15 of 23 risk factors were significant. The PAT score was then developed accordingly. The PAT score had significantly better discrimination (ROC 0.9671) than the BRUGADA-RISK score (ROC 0.7210; P = .006), Shanghai Score System (ROC 0.7079; P = .003), and Sieira et al score (ROC 0.8174; P = .026) in an external validation cohort. PAT score ≥ 10 predicted the first MAE with 95.5% sensitivity and 89.1% specificity (ROC 0.9460) and the recurrent MAE (ROC 0.7061) with 15.4% sensitivity and 93.3% specificity. Conclusion: The PAT score was shown to be useful in predicting MAE for primary prevention in patients with Brugada syndrome.