CHA2DS2-VASc score as a prognostic indicator in patients with atrial fibrillation undergoing coronary stenting

Abstract

Background/aim Patients with atrial fibrillation (AF) and coronary stenting had a poor prognosis. This study aimed to assess the accuracy of CHA 2 DS 2 -VASc score for predicting and grading adverse clinical outcomes in this population. Materials and methods We reviewed the clinical data of all patients with previously documented nonvalvular AF who underwent coronary stenting between January 2010 and June 2015 in 12 hospitals of Beijing, China. The study population was divided into three groups: 1) Low CHA 2 DS 2 -VASc score, ≦ 2 points, 2) Intermediate score, 3–4 points, and 3) High score, ≧ 5 points. Major adverse cardiac/cerebrovascular events (MACCE) were defined as a composite of all-cause death, nonfatal myocardial infarction, repeat revascularization and ischemic stroke/systemic thromboembolism (IS/SE). Results A total of 2394 patients (men: 72.3% vs. women: 27.7%, median age: 67 years) were included, with the CHA 2 DS 2 -VASc score of 3.6 ± 1.6. The median follow-up duration was 36.2 months. All-cause mortality increased 3 folds from the low score (4.8%) to the high score group (15.8%). The high score group had more IS/SE (7.4%) and MACCE (26.3%). The CHA 2 DS 2 -VASc score ≧ 5 points was independently associated with all-cause death (hazard ratio [HR]: 2.303, 95% confidence interval [CI]: 1.492–3.555), IS/SE (HR: 4.169, 95% CI: 2.216–7.845) and MACCE (HR: 1.468, 95% CI: 1.113–1.936) on multivariate Cox proportional hazards regression. The area under the receiver operating characteristic curve of the CHA 2 DS 2 -VASc score was 0.644 (95% CI: 0.624–0.663) for all-cause death, 0.647 (95% CI: 0.627–0.666) for IS/SE, and 0.592 (95% CI: 0.572–0.611) for MACCE. Conclusion CHA 2 DS 2 -VASc score was a reliable prognostic indicator in patients with AF and coronary stenting.

Evaluating the effectiveness of echocardiographic guidance in diminishing postoperative wound complications for left atrial appendage closure: A clinical retrospective study

“…A total of 200 patients were identified, with 100 patients in the echocardiographically guided group (Group E) and 100 in the non‐guided group (Group N). Inclusion criteria were patients aged 18 years and above with a CHA2DS2‐VASc score ≥2 11 . Exclusion criteria included patients with a history of allergic reactions to echocardiographic contrast agents, previous LAA surgery or incomplete medical records.…”

“…Inclusion criteria were patients aged 18 years and above with a CHA2DS2-VASc score ≥2. 11 Exclusion criteria included patients with a history of allergic reactions to echocardiographic contrast agents, previous LAA surgery or incomplete medical records.…”