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Predicting Recurrence of Vasovagal Syncope: A Simple Risk Score for the Clinical Routine
Author(s) -
AYDIN MUHAMMET A.,
MAAS RENKE,
MORTENSEN KAI,
STEINIG TOBIAS,
KLEMM HANNO,
RISIUS TIM,
MEINERTZ THOMAS,
WILLEMS STEPHAN,
MORILLO CARLOS A.,
VENTURA RODOLFO
Publication year - 2009
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2008.01352.x
Subject(s) - vasovagal syncope , medicine , syncope (phonology) , proportional hazards model , tilt table test , receiver operating characteristic , cardiology , framingham risk score , heart rate , blood pressure , disease
Background:Predictors for recurrence of syncope are lacking in patients with vasovagal syncope. The aim of this study was to identify risk factors for recurrence of syncope and develop a simple prognostic risk score of clinical value.Methods:Two hundred seventy‐six patients with a history of vasovagal syncope were prospectively followed for 2 years. Diagnosis of vasovagal syncope was based on clinical history and negative standard work‐up. Inclusion in the study was independent from the result of the head‐up tilt test, which was performed in all cases. Risk factors for syncope recurrence were evaluated by the Cox proportional hazards regression model and implemented in a risk score, which was validated with the log‐rank test and an internal cross‐validation.Results:The Cox‐regression analysis identified the number of previous syncopal events, history of bronchial asthma, and female gender as predictors for syncope recurrence (all P < 0.05). In contrast, head‐up tilt test response had no predictive value (P = 0.881). Developing a risk score, study patients were identified as having high (recurrence rate during 2 years of follow‐up: 37.2%), intermediate (24.8%), and low (6.5%) risk for syncope recurrence (receiver operating characteristic [ROC] of score 0.83, P < 0.01; Log‐rank test for event‐free survival, P < 0.005).Conclusions:In patients with vasovagal syncope, risk of recurrence can be stratified and is predictable based on a simple risk score.