Importance and usage of the CHA2DS2-VASc score in predicting acute stent thrombosis

Ünal, Sefa; Açar, Burak; Yayla, Çağrı; Balcı, Mustafa; Ertem, Ahmet Göktuğ; Kara, Meryem; Maden, Orhan; Dereagzi, Senay Funda

doi:10.1097/mca.0000000000000388

Cited by 27 publications

(20 citation statements)

References 23 publications

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“…Supporting the previous studies, this result suggests that CHADS2 VASc score may be indirectly associated with the development of noreflow [25]. Ünal et al demonstrated a relationship between acute stent thrombosis and CHA2DS2-VASc score in patients without atrial fibrillation [15]. In our study, CHA2DS2-VASc score was demonstrated to be an independent predictor of high thrombus burden.…”

Section: Discussionsupporting

confidence: 90%

“…In addition, the association between CHA2DS2-VASc score and acute stent thrombosis, noreflow, and thromboembolism and thrombosis in atrial fibrillation, which has been demonstrated in the previous studies may be helpful to explain the reason of its association with high thrombus burden in STEMI patients [8,15,25]. Again for the same reasons, we think it is not surprising to observe that CHADS VASc is a predictor of the development of high thrombus burden.…”

Section: Discussionsupporting

confidence: 56%

“…Based on the CHA2DS2-VASc score, patients were given 1 point for congestive heart failure, hypertension, being aged between 65 to 74 years, diabetes mellitus, vascular disease (prior MI, peripheral artery disease, aortic plaque) and female gender; and 2 points for being aged 75 years and over, and previous cerebrovascular events (Transient Ischemic Attack (TIA)/stroke) [8]. One point was added to the score in all patients considering that they were admitted with STEMI [15].…”

Section: Definitionmentioning

confidence: 99%

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CHA2DS2-VASc score is a predictor of angiographic high thrombus burden in patients with ST-Segment elevation myocardial infarction

Bayramoğlu¹

2019

Ann Clin Anal Med

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Aim: High thrombus burden is an important indicator of complications that may occur in STEMI patients undergoing percutaneous coronary intervention. The CHA2DS2-VASc score is known as the score which is closely related to thrombosis. In this study, we aimed to investigate the association between CHA2DS2-VASc score and angiographic thrombus burden in patients with STEMI who underwent pPCI. Material and Method: A total of 570 consecutive STEMI patients who underwent pPCI were included in the study. The patients were divided into 2 groups: a high thrombus burden group and low thrombus burden group. The CHA2DS2-VASc scores were calculated for all patients. Results: The CHA2DS2-VASc scores were significantly higher in the high thrombus burden group, compared to the low thrombus burden group. Multivariate regression analysis showed that, prior MI history

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 56%

Section: Definitionmentioning

confidence: 99%

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CHA2DS2-VASc score is a predictor of angiographic high thrombus burden in patients with ST-Segment elevation myocardial infarction

Bayramoğlu¹

2019

Ann Clin Anal Med

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“…Similarly, in our cohort, elevated CHA 2 DS 2 VASc scores were associated with an increased incidence of in-hospital mortality. In a recent study on the association between CHA 2 DS 2 VASc scores and acute stent thrombosis in patients with stable coronary artery disease and acute coronary syndrome, a score of 3 or more had an independent predictive value for acute stent thrombosis [8]. We found similar results in our study with a larger cohort of only STEMI patients.…”

Section: Discussionsupporting

confidence: 81%

“…A previous study reported that the CHA 2 DS 2 VASc score was an independent predictor of in-hospital and long-term mortality in patients with acute coronary syndrome [7]. In addition, a recent study found an association between the CHA 2 DS 2 VASc score and acute stent thrombosis in patients with stable coronary artery disease [8]. In light of these data, the aim of the present study was to examine the potential utility of admission CHA 2 DS 2 VASc scores in predicting acute stent thrombosis in STEMI patients who have undergone a pPCI.…”

Section: Introductionmentioning

confidence: 99%

Association of the CHA<sub>2</sub>DS<sub>2</sub>VASc Score with Acute Stent Thrombosis in Patients with an ST Elevation Myocardial Infarction Who Underwent a Primary Percutaneous Coronary Intervention

Tanık

Aruğaslan

Çınar³

et al. 2018

Med Princ Pract

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Objective: In this study, we aimed to determine the predictive value of the CHA₂DS₂VASc score for acute stent thrombosis in patients with an ST elevation myocardial infarction treated with a primary percutaneous coronary intervention (pPCI). Methods: This was a retrospective study conducted among 3,460 consecutive patients with STEMI who underwent a pPCI. The stent thrombosis was considered a definite or confirmed event in the presence of symptoms suggestive of acute coronary syndrome and angiographic confirmation of stent thrombosis based on the diagnostic guidelines of the Academic Research Consortium. The stent thrombosis was classified as acute if it developed within 24 h. Results: The mean CHA₂DS₂VASc score was 3.29 ± 1.73 in the stent thrombosis group, whereas it was 2.06 ± 1.14 in the control group (p < 0.001). In multivariable logistic regression analysis, CHA₂DS₂VASc scores ≥ 4 were independently associat ed with acute stent thrombosis (OR = 1.64; 95% CI 1.54–1.71, p < 0.001). In a receiver operating characteristic curve analysis, the best cut-off value for the CHA₂DS₂VASc score was ≥4, with 60% sensitivity and 73% specificity. Of note, pa tients with a CHA₂DS₂VASc score of 4 had a 4.3 times higher risk of acute stent thrombosis compared to those with a CHA₂DS₂VASc score of 1. Conclusions: The CHA₂DS₂VASc score may be a significant independent predictor of acute stent thrombosis in patients with STEMI treated with a pPCI. Therefore, the CHA₂DS₂VASc score may be used to assess the risk of acute stent thrombosis in patients with STEMI following a pPCI.

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Acute Intraprocedural Thrombosis After Flow Diverter Stent Implantation: Risk Factors and Relevance of Standard Observation Time for Early Detection and Management

et al. 2022

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Purpose Acute intraprocedural thrombosis (AIT) is a severe complication of flow diverter stent (FDS) implantation for the treatment of intracranial aneurysms. Even though device-related thromboembolic complications are well known, there are no acknowledged risk factors nor defined surveillance protocols for their early detection. This study aimed to demonstrate that an angiographic active surveillance is effective to detect and treat AIT. Furthermore, we investigated risk factors for the occurrence of AIT. Methods A prospective institutional protocol consisting of a defined observation period of 30 min following FDS deployment was established to detect AIT. Overall incidence, as well as the efficacy and safety of AIT treatment were assessed. Moreover, radiological and clinical outcomes of patients with AIT were analyzed. The influence of various patient- and procedure-related factors on the occurrence of AIT was investigated using multivariable forward logistic regression. Results During active surveillance twelve cases of AIT were observed among a total of 161 procedures (incidence: 7.5%). The median time of first observation was 15.5 min (IQR 9.5) after FDS implantation. The early recognition of AIT ensured a prompt treatment with intravenous application of a glycoprotein IIb/IIIa inhibitor, which led to complete thrombus resolution in all cases without hemorrhagic complications. Patients with pre-existing arterial hypertension and side branches originating from the aneurysmal sac had a higher risk of AIT (respectively OR, 9.844; OR, 3.553). There were two cases of re-thrombosis in the short-term postoperative period, of whom one died. The remaining patients with AIT had a good clinical outcome. Conclusion Active surveillance for 30 min after FDS implantation is an effective strategy for early detection and ensuing treatment of AIT and can thus prevent secondary sequalae. Hypertension and side branches originating from the aneurysmal sac may increase the risk of AIT.

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Importance and usage of the CHA2DS2-VASc score in predicting acute stent thrombosis

Abstract: A CHA2DS2-VASc score of greater than 2 was found to be an independent predictor for incidence of ST. The role of the CHA2DS2-VASc score in predicting ST has not been investigated earlier in an AF-free population and our study is the first to explore this aspect.

Cited by 27 publications

References 23 publications

CHA2DS2-VASc score is a predictor of angiographic high thrombus burden in patients with ST-Segment elevation myocardial infarction

CHA2DS2-VASc score is a predictor of angiographic high thrombus burden in patients with ST-Segment elevation myocardial infarction

Association of the CHA<sub>2</sub>DS<sub>2</sub>VASc Score with Acute Stent Thrombosis in Patients with an ST Elevation Myocardial Infarction Who Underwent a Primary Percutaneous Coronary Intervention

Acute Intraprocedural Thrombosis After Flow Diverter Stent Implantation: Risk Factors and Relevance of Standard Observation Time for Early Detection and Management

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