Objective The CHA2DS2-VASc score, a system which has been initially recommended for the assessment of thromboembolic risk in patients with atrial fibrillation (AF), arouses attention in the field of adverse coronary events. The purpose of this study was to explore the predictive value of preprocedural CHA2DS2-VASc score on ISR in patients after drug-eluting stent (DES) implantation. Methods To further investigate the relationship between CHA2DS2-VASc scores and ISR after DES, a retrospective study of DES was carried on. Additionally, the preoperative variables for the ISR and control groups were contrasted. Predictive factors were chosen using the optimal subset regression. We validate the model using internal validation. The prediction model was evaluated using the receiver operator characteristic (ROC) analysis. Results We used a 3:7 ratio to create an experimental group and a validation group, and then ran a stepwise regression with the data from each of the two groups. The results showed that CHA2DS2-VASc score was an independent risk factor for ISR in both the experimental (p = 0.0139) and validation groups (p = 0.0014), and both had significant predictive value for ISR. The area of the ROC curve was greater than 0.5 in both groups (AUC = 0.78, 0.719, respectively) indicating that the model fit was good in both groups. Conclusion The CHA2DS2-VASc score is a reliable predictor of in-stent restenosis (ISR) after DES implantation.
Introduction: Multiple myeloma (MM) is a hematologic disorder that is relatively common in the elderly population. Given the rapid development, limited survival, and poor prognosis of the majority of patients, a definitive, prompt diagnosis is critical for treating individuals with multiple myeloma accompanied with cardiac amyloidosis. The incidence of myocardial amyloidosis with MM, relatively speaking, is low and early clinical manifestations are nonspecific. Atrial thrombi, with low detection, are a hallmark of poor prognosis of patients diagnosed MM with amyloidosis cardiomyopathy. Case Report: Aiming to serve as useful feedback information for judging the prognosis of target patient, we now analyzed the clinical data of an elderly female with atrial thrombi as the main symptom and impaired cardiac function combined with echocardiography electrocardiography (ECG), laboratory data, cell Congo Red staining and other manifestations to diagnose amyloidosis combined with MM. Conclusion: The formation of atrial thrombi is closely related to the prognosis of myocardial amyloidosis and in order to identify atrial thrombi early and to intervene early, transesophageal ultrasound should be included as part of routine investigations in patients with myocardial amyloidosis.
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