Modified CHA2DS2-VASc score predicts in-hospital mortality and procedural complications in acute coronary syndrome treated with percutaneous coronary intervention

Abugroun, Ashraf; Hassan, Abdalla; Gaznabi, Safwan; Ayinde, Hakeem; Subahi, Ahmed; Samee, Mohammed; Shroff, Adhir; Klein, Lloyd W.

doi:10.1016/j.ijcha.2020.100532

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…3 Additionally, AF and other cardiovascular diseases share common risk factors, which are part of the components of the CHA 2 DS 2 -VASc score. Thus, several studies explored the predictive value of the CHA2DS2-VASc score in patients with cardiovascular diseases such as heart failure, 4,5 acute coronary syndrome 6 (ACS), valvular heart disease 7 (VHD) and thromboembolic events 8 (TE). However, the prognostic value of this score in CCU patients remains unclear.…”

Section: Introductionmentioning

confidence: 99%

The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

Cheng

Kang

Lin

et al. 2022

Clin Appl Thromb Hemost

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Background The CHA2DS2-VASc score has been associated with the prognosis of cardiovascular diseases. This study aimed to explore the association between the CHA2DS2-VASc score and all-cause mortality in coronary care unit (CCU) patients. Methods The study was based on the Medical Information Mart for Intensive Care (MIMIC) III database. CCU patients were divided into two groups according to CHA2DS2-VASc score: 0-3 (low risk)，4-9 (intermediate and high risk). The primary outcome was 30-day mortality, and the secondary endpoints included in-hospital, 1-year, and 5-year mortality. Propensity score matching (PSM) and sensitivity analyzes for the confounders were also performed. The restricted cubic splines flexibility model was used to demonstrate the relation between red blood cell volume distribution width (RDW), blood urea nitrogen (BUN), platelet, white blood cell (WBC), hemoglobin, phosphorus, glucose, potassium, sodium and 30-day mortality in the 0-3 score versus the 4-9 score groups after PSM. Results Among 4491 eligible patients, 988 patients with low CHA2DS2-VASc scores and 988 patients with intermediate and high CHA2DS2-VASc scores had similar propensity scores and were included in the analyzes. In the survival analysis, the patients with intermediate and high CHA2DS2-VASc scores were associated with higher 30-day mortality [hazard ratio (HR): 1.11; 95% confidence interval (CI), 1.02–1.20, P = .014], 1-year mortality [HR: 1.13; 95%CI, 1.06–1.19, P < .001], and 5-year mortality [HR: 1.13; 95%CI, 1.07–1.18, P < .001]. The interaction for 30-day mortality among subgroups was not significant between the 0-3 score versus the 4-9 score groups. The restricted cubic splines for 30-day mortality demonstrated an L-shaped trajectory for platelets and hemoglobin, a J-shaped trajectory for WBC, glucose and potassium, and a U-shaped trajectory for sodium, respectively (all nonlinear P <.001). Conclusions A high CHA2DS2-VASc score was an independent risk for 30-day, 1-year, and 5-year mortality for CCU patients.

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Section: Introductionmentioning

confidence: 99%

The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

Cheng

Kang

Lin

et al. 2022

Clin Appl Thromb Hemost

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“…Several definitions and scoring systems have been proposed, which seek to integrate clinical, coronary, LV, and technical aspects to predict elevated procedural risk, with varying degrees of validation, but none have been universally adopted. 13,[30][31][32][33][34] In addition to identifying patients who are most likely to benefit from MCS, determining the ideal trial population requires consideration of feasibility and generalizability. The choice of participating centers is important: recruiting centers need to have high-volume complex PCI programs, experience of pLVAD device deployment, expertise in large-bore arterial access, and a track record of recruitment to randomized clinical trials, while the use of pLVAD devices must not be so engrained that a perceived lack of equipoise prevents either the recruitment of consecutive patients or reduces the confidence of operators in safely delivering interventions without the device, which could lead to a high crossover rate.…”

Section: Methodological Challenges In Designing High-risk Pci Trials ...mentioning

confidence: 99%

Percutaneous Left Ventricular Unloading During High-Risk Coronary Intervention: Rationale and Design of the CHIP-BCIS3 Randomized Controlled Trial

Ryan,

Ezad,

Webb

et al. 2024

Circ: Cardiovascular Interventions

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INTRODUCTION: Percutaneous coronary intervention for complex coronary disease is associated with a high risk of cardiogenic shock. This can cause harm and limit the quality of revascularization achieved, especially when left ventricular function is impaired at the outset. Elective percutaneous left ventricular unloading is increasingly used to mitigate adverse events in patients undergoing high-risk percutaneous coronary intervention, but this strategy has fiscal and clinical costs and is not supported by robust evidence. METHODS: CHIP-BCIS3 (Controlled Trial of High-Risk Coronary Intervention With Percutaneous Left Ventricular Unloading) is a prospective, multicenter, open-label randomized controlled trial that aims to determine whether a strategy of elective percutaneous left ventricular unloading is superior to standard care (no planned mechanical circulatory support) in patients undergoing nonemergent high-risk percutaneous coronary intervention. Patients are eligible for recruitment if they have severe left ventricular systolic dysfunction, extensive coronary artery disease, and are due to undergo complex percutaneous coronary intervention (to the left main stem with calcium modification or to a chronic total occlusion with a retrograde approach). Cardiogenic shock and acute ST-segment–elevation myocardial infarction are exclusions. The primary outcome is a hierarchical composite of all-cause death, stroke, spontaneous myocardial infarction, cardiovascular hospitalization, and periprocedural myocardial infarction, analyzed using the win ratio. Secondary outcomes include completeness of revascularization, major bleeding, vascular complications, health economic analyses, and health-related quality of life. A sample size of 250 patients will have in excess of 80% power to detect a hazard ratio of 0.62 at a minimum of 12 months, assuming 150 patients experience an event across all follow-up. CONCLUSIONS: To date, 169 patients have been recruited from 21 National Health Service hospitals in the United Kingdom, with recruitment expected to complete in 2024. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT05003817.

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Modified CHA2DS2-VASc score predicts in-hospital mortality and procedural complications in acute coronary syndrome treated with percutaneous coronary intervention

Cited by 2 publications

References 19 publications

The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

Percutaneous Left Ventricular Unloading During High-Risk Coronary Intervention: Rationale and Design of the CHIP-BCIS3 Randomized Controlled Trial

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Modified CHA2DS2-VASc score predicts in-hospital mortality and procedural complications in acute coronary syndrome treated with percutaneous coronary intervention

Cited by 2 publications

References 19 publications

The Association Between High CHA2DS2-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

The Association Between High CHA2DS2-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

Percutaneous Left Ventricular Unloading During High-Risk Coronary Intervention: Rationale and Design of the CHIP-BCIS3 Randomized Controlled Trial

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The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients

The Association Between High CHA₂DS₂-VASc Scores and Short and Long-Term Mortality for Coronary Care Unit Patients