CHA2DS2-VASC Score as a Predictor of Coronary Artery Disease: A Cross Sectional Observational Study

Abstract

Background: The CHA2Ds2-VASC was was revealed to be a predictor for thromboembolism event in patients who do not have atrial fibrillation or who have supra ventricular arrhythmia. The aim of this work was to evaluate the role of CHA2DS2 – VASC score in prediction of coronary artery disease.
 Methods: This cross sectional observational study included 150 patients underwent coronary angiography for diagnosis and treatment of CAD. There were 59 patients with ACS (including STEMI and Non-STEMI) and 91 patients with no ACS. All patients were subjected to complete history taking, clinical, general examination and local cardiac examination. Standard 12-lead ECG was obtained within 10 minutes of first medical contact (FMC) according to ESC guidelines. Baseline laboratory tests were done including serum creatinine, INR, hemoglobin, platelets, cholesterol and triglycerides. Arterial coronary angiography (Femoral approach), right and left coronary imaging and echocardiographs were performed.
 Results: The incidence of HTN, CHF, DM and Vascular disease was statistically significantly higher in the cases with ACS as compared with the cases with no ACS. The total mean Gensini score was significantly higher in the cases with ACS as compared with the cases with no ACS. There was a statistically significantly strong positive correlation between CHA2DS2‐VASc Score and Gensini score. The best cut-off point of CHA2DS2‐VASc Score to differentiate between cases with ACS and no ACS WAS > 2 with 79.7% sensitivity and 56% specificity. With univariate regression analysis, increasing age, CHF, DM, previous stroke, vascular disease and increasing CHADS-VASC score were reported as risk factors for vessel affection, however with multivariate regression analysis CHF, DM and increasing CHADS-VASC score were shown as independent risk factors of vessel affection
 Conclusions: CHA2DS2-VASc score could be utilized as a useful diagnostic and predictor tool in cases with CAD. Patients with higher CHA2DS2-VASc scores had higher risks of cardiovascular disease severity.

Detection of Adverse Cardiac Events in Patients with Acute Myocardial Infarction

“…As regards the score of the current study patients was ranging from 0 to 4. Similarly, Shehata et al (17) in a previously conducted study found that CHADs-VASc score among acute coronary syndrome was 3.39 (SD 1.22).…”

“…In this study, 45.0% of the patients was hypertensives. Meanwhile, compared with normal blood pressure, the risk of MI increased with AHA hypertension stage in both sexes and was consistently higher among women than men in many studies (16,17) . The difference is that the present study had male predominance, with no control group included to determine whether hypertension is a risk factor or not.…”