The CHA2DS2-VASc score for predicting atrial fibrillation in patients presenting with ST elevation myocardial infarction: prospective observational study

Abstract

BACKGROUND: Atrial fibrillation (AF) is the most common form of supraventricular arrhythmia following ST-elevation myocardial infarction (STEMI). The CHA 2 DS 2-VASc and CHADS 2 scores are used to estimate thromboembolic risk in cases of AF. Their usefulness in predicting the development of AF in patients presenting STEMI is unknown. OBJECTIVE: To evaluate the predictive value of the CHADS 2 and CHA 2 DS 2-VASc scores in patients with AF following STEMI. DESIGN AND SETTING: This prospective cohort study on 696 patients with STEMI was conducted at a tertiary-level cardiology clinic in a public university hospital. METHODS: Models including clinical and laboratory parameters were constructed to test the predictive value of CHADS 2 and CHA 2 DS 2-VASc scores. Patients were divided into two groups: with and without AF. Predictors of AF were determined using multivariate regression analysis. RESULTS: In the patients with AF, CHADS 2 and CHA 2 DS 2-VASc scores were significantly higher than in those without AF (for both P < 0.001). Factors associated with AF in multivariate analyses included CHA 2 DS 2-VASc score (odds ratio, OR: 1.48; 95% confidence interval, CI: 1.25-1.75; P < 0.001), peak creatine kinase-myocardial binding (OR: 1.002; 95% CI: 1.00-1.003; P = 0.0024), duration of the coronary intensive care unit stay (OR: 1.69; 95% CI: 1.24-12.30; P = 0.001) and no use of renin-angiotensin system blockers (OR: 2.16; 95% CI: 1.14-4.10; P = 0.0017). Receiver operating characteristic curve analyses showed that CHA 2 DS 2-VASc scores were significant predictors for new-onset AF (C-statistic: 0.698; 95% CI: 0.631-0.765; P < 0.001). CONCLUSION: CHADS 2 and CHA 2 DS 2-VASc scores predicted new AF in patients presenting STEMI. The CHA 2 DS 2-VASc score for predicting atrial fibrillation in patients presenting with ST elevation myocardial infarction: prospective observational study | ORIGINAL ARTICLE

Usefulness of CHADS2, R2CHADS2, and CHA2DS2‐VASc scores for predicting incident atrial fibrillation in heart failure with preserved ejection fraction patients

“…11 In recent years, several studies have suggested that CHADS2, R2CHADS2, and CHA2DS2-VASc could predict new occurrence of AF in the general population, [12][13][14][15] patients after AF ablation, 16 or patients with acute coronary syndrome. 17,18 In addition, the individual components in these scores are also the potential risk factors of AF in HF patients. Therefore, it would be interesting to determine if the CHADS2, R2CHADS2, and CHA2DS2-VASc scores could predict AF in HFpEF patients.…”

CHADS2-VASc skorunun primer percutan koroner girişim yapılan ST elevasyonlu miyokart enfarktüslü hastalarda ST segment rezolusyonunu öngörmedeki yararlılığı

“…Recent study has shown an association between CHA2DS2-VASc risk score and reperfusion failure after thrombolytic therapy in patients with STEMI 7 . Moreover, we showed that CHA2DS2-VASC score have been predicted AF following STEMI and associated with epicardial fat tissue 8,9 .…”

Assessment of the ability of the CHA2DS2-VASc scoring system to grade left atrial function by 2D speckle-tracking echocardiography

“…The application of this scoring system for the prediction of thromboembolic events is not restricted to patients with AF; it can also be applied to patients without AF such as those with heart failure [2] or chronic obstructive pulmonary disease [3] and those after coronary artery bypass grafting (CABG) [4,5]. It can also predict the occurrence of AF in varieties of conditions such as diabetes [6], systemic lupus erythematosus [7], myocardial infarction [8], and cardiac surgeries including CABG [9][10][11]. In addition, the CHA 2 DS 2 -VASc score plays a role in the prediction of events other than stroke and AF such as failed reperfusion after thrombolytic therapy [12], the no-reflow phenomenon [13], and contrast-induced nephropathy [14].…”