CHA2DS2-VASc and R2-CHA2DS2-VASc scores predict in-hospital and post-discharge outcome in patients with myocardial infarction

Abstract

IntroductionThe CHA2DS2-VASc and R2-CHA2DS2-VASc scores were initially designed to evaluate the risk of cerebrovascular events in patients with atrial fibrillation. However, these scales consist of parameters which are well known as general risk factors for cardiovascular events.AimTo assess the role of the CHA2DS2-VASc and R2-CHA2DS2-VASc scores in predicting outcome of patients with myocardial infarction (MI).Material and methodsWe enrolled 212 consecutive patients with both ST-elevation and non-ST-elevation MI referred for primary percutaneous coronary intervention (PCI). Patients were divided into two groups depending on the CHA2DS2-VASc score: ≤ 3 (low score) and > 3 points (high score).ResultsThe group with a CHA2DS2-VASc score > 3 points consisted of 93 (44%) patients. Follow-up was available in 200 (94.3%) patients with median duration of 10 (Q1: 6; Q3: 13) months. During the follow-up all-cause mortality was greater in patients from the high score group (21%) compared to patients with lower scores (8%) (p = 0.009). Recurrent MI was found in 4% of patients from the low score group and in 13% of patients from the high score group (p = 0.024). The combined endpoint of cardiovascular mortality, recurrent non-fatal MI and non-fatal stroke occurred in 13% of lower score patients and in 30% of patients with a score > 3 points (p = 0.002). In a Cox regression model both scores were predictors of all-cause mortality with a hazard ratio of 1.31 per 1 point increase for the CHA2DS2-VASc score (p = 0.004) and 1.36 for the R2-CHA2DS2-VASc score (p < 0.001).ConclusionsThe CHA2DS2-VASc and R2-CHA2DS2-VASc scores predict in-hospital and post-discharge outcome in patients with acute MI undergoing primary PCI.

Does CHA2DS2-VASc score predict mortality in chronic kidney disease?

“…In the same way, R2CHA2DS2VASc score awards an additional 2 points for CrCl < 60 mL/min and GFR < 60 mL/min/1.73 m 2 and has already been used to predict long-term outcomes for patients with coronary artery disease (CAD)20 and acute coronary syndromes (ACS) [ 20 – 22 ].…”

CHA2DS2-VASc-HSF Score may Better Predict the Development of Total Coronary Artery Occlusion in Acute Coronary Syndrome

“…It follows that several studies showed that higher scores correlated with the presence or severity of coronary artery disease (CAD), contrast-induced nephropathy after percutaneous coronary intervention (PCI), no-reflow phenomenon in patients with acute myocardial infarction (AMI), in-stent restenosis, acute stent thrombosis after acute coronary syndrome and cardiovascular prognosis. [4][5][6][7][8][9] Recently, a new score, CHA2DS2-VASc-HSF, was developed by adding smoking, hyperlipidemia, and family history of CAD to the CHA2DS2-VASc score; in addition, the female gender was replaced by the male gender. 10 Recent studies reported that this new score showed better performance compared with the CHADS2 and CHA2DS2-VASc scores in evaluating CAD.…”

New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

“…The components of these two scores are associated with atherosclerosis, vascular spasm, and microvascular dysfunction, which overlap the risk factors of NRP [7]. Several recent studies have also shown that the CHA 2 DS 2 -VASc scores are associated with the severity of coronary artery disease, its prognosis, and NRP in patients with acute MI, contrast-induced nephropathy after PPCI for acute coronary syndrome, in-stent restenosis, acute stent thrombosis, mechanical mitral valve thrombosis, and right ventricular dysfunction [8][9][10][11][12][13][14][15][16].…”