A Primary Prevention Clinical Risk Score Model for Patients With Brugada Syndrome (BRUGADA-RISK) - Archive ouverte HAL Access content directly
Journal Articles JACC: Clinical Electrophysiology Year : 2021

A Primary Prevention Clinical Risk Score Model for Patients With Brugada Syndrome (BRUGADA-RISK)

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Juan Ramón Gimeno-Blanes
  • Function : Author
Pedro Silverio Antonio
  • Function : Author
Francisco Morosco Costa
  • Function : Author
Mario João Sousa
  • Function : Author
Shohreh Honarbakhsh
  • Function : Author
Rui Providencia
  • Function : Author
Jorge Garcia-Hernandez
  • Function : Author
Claire A Martin
  • Function : Author
Ross J Hunter
  • Function : Author
Wei y Lim
  • Function : Author
Claire Kirkby
  • Function : Author
Adam J Graham
  • Function : Author
Victor Waldmann
Eloi Marijon
Carmen Munoz-Esparza
  • Function : Author
Javier Lacunza
  • Function : Author
Juan Ramón Gimeno-Blanes
  • Function : Author
Benedicte Ankou
  • Function : Author
Philippe Chevalier
  • Function : Author
Nátalia Antonio
  • Function : Author
Luís Elvas
  • Function : Author
Silvia Castelletti
  • Function : Author
Lia Crotti
  • Function : Author
Peter Schwartz
Mauricio Scanavacca
  • Function : Author
Francisco Darrieux
  • Function : Author
Luciana Sacilotto
  • Function : Author
Johanna Mueller-Leisse
  • Function : Author
Christian Veltmann
  • Function : Author
Alessandro Vicentini
  • Function : Author
Andrea Demarchi
  • Function : Author
Nuno Cortez-Dias
  • Function : Author
Pedro Silverio Antonio
  • Function : Author
João de Sousa
  • Function : Author
Pedro Adragao
  • Function : Author
Diogo Cavaco
  • Function : Author
Francisco Morosco Costa
  • Function : Author
Ziad Khoueiry
  • Function : Author
Serge Boveda
Mario João Sousa
  • Function : Author
Zeynab Jebberi
  • Function : Author
Patrick Heck
  • Function : Author
Sarju Mehta
  • Function : Author
Giulio Conte
  • Function : Author
Tardu Ozkartal
  • Function : Author
Angelo Auricchio
Martin D Lowe
  • Function : Author
Richard J Schilling
  • Function : Author
David Prieto-Merino
  • Function : Author
Pier D Lambiase
  • Function : Author

Abstract

The goal of this study was to develop a risk score model for patients with Brugada syndrome (BrS). BACKGROUND Risk stratification in BrS is a significant challenge due to the low event rates and conflicting evidence. METHODS A multicenter international cohort of patients with BrS and no previous cardiac arrest was used to evaluate the role of 16 proposed clinical or electrocardiogram (ECG) markers in predicting ventricular arrhythmias (VAs)/sudden cardiac death (SCD) during follow-up. Predictive markers were incorporated into a risk score model, and this model was validated by using out-of-sample cross-validation. RESULTS A total of 1,110 patients with BrS from 16 centers in 8 countries were included (mean age 51.8 AE 13.6 years; 71.8% male). Median follow-up was 5.33 years; 114 patients had VA/SCD (10.3%) with an annual event rate of 1.5%. Of the 16 proposed risk factors, probable arrhythmia-related syncope (hazard ratio [HR]: 3.71; p < 0.001), spontaneous type 1 ECG (HR: 3.80; p < 0.001), early repolarization (HR: 3.42; p < 0.001), and a type 1 Brugada ECG pattern in peripheral leads (HR: 2.33; p < 0.001) were associated with a higher risk of VA/SCD. A risk score model incorporating these factors revealed a sensitivity of 71.2% (95% confidence interval: 61.5% to 84.6%) and a specificity of 80.2% (95% confidence interval: 75.7% to 82.3%) in predicting VA/SCD at 5 years. Calibration plots showed a mean prediction error of 1.2%. The model was effectively validated by using out-of-sample cross-validation according to country. CONCLUSIONS This multicenter study identified 4 risk factors for VA/SCD in a primary prevention BrS population. A risk score model was generated to quantify risk of VA/SCD in BrS and inform implantable cardioverterdefibrillator prescription.
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Origin : Publication funded by an institution

Dates and versions

hal-03231387 , version 1 (20-05-2021)

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Attribution - NonCommercial - NoDerivatives - CC BY 4.0

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Juan Ramón Gimeno-Blanes, Pedro Silverio Antonio, Francisco Morosco Costa, Mario João Sousa, Shohreh Honarbakhsh, et al.. A Primary Prevention Clinical Risk Score Model for Patients With Brugada Syndrome (BRUGADA-RISK). JACC: Clinical Electrophysiology, 2021, 7 (2), pp.210-222. ⟨10.1016/j.jacep.2020.08.032⟩. ⟨hal-03231387⟩

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