Usefulness of the 2MACE score as a predictor of long-term all-cause mortality in patients with atrial fibrillation

Abstract

INTRODUCTION: 2MACE is a risk assessment score designed to stratify cardiovascular risk in patients with atrial fibrillation (AF). Early detection of increased cardiovascular risk is of vital importance in this population, as it helps reduce mortality and morbidity rates. OBJECTIVES: This study aimed to assess the utility of the 2MACE score in predicting long-term mortality in patients with AF. PATIENTS AND METHODS: This was a post hoc analysis of a prospective observational cohort study including consecutive patients with nonvalvular AF, who were followed for a median duration of 81 months. RESULTS: The final analysis included 1351 patients (men, 53.1%; median [interquartile range] age, 71 [62-80] years). During the follow-up, 142 patients (10.5%) died. Deceased patients were more often classified as high risk according to the 2MACE score than survivors (80.3% vs 53.2%; P <0.0001). The receiver operator characteristic curve analysis demonstrated that the 2MACE score had a good predictive value for long-term all-cause mortality (area under the curve, 0.73; 95% CI, 0.69-0.78). The mortality rate was significantly increased in patients with a 2MACE score of 3 or higher (hazard ratio, 3.40; 95% CI, 2.33-5.49). CONCLUSIONS: The 2MACE score is a good predictor of long-term all-cause mortality in patients with AF. A progressive increase in the mortality rate was observed with an increasing 2MACE score.