Predictive Accuracy of the CHA2 DS2 -VASc-HSF Score in Determining One-Year Cardiovascular Outcomes in Patients with Non-ST-Elevation Acute Coronary Syndrome: A Retrospective Study

Abstract

Introduction: To investigate the predictive accuracy of the CHA 2 DS 2 -VASc-HSF score in predicting the one-year mortality and major adverse cardiac and cerebrovascular events (MACCEs) in patients with non-STelevation acute coronary syndrome (NSTE-ACS). Patients and Methods:In this retrospective study, the study cohort was divided in to two groups based on the median CHA 2 DS 2 -VASc-HSF score: low-risk group (≤ 4 points) and high-risk group (> 4 points). Results:We enrolled 394 patients with NSTE-ACS (mean age: 58.7 ± 11.8 years). The CHA 2 DS 2 -VASc-HSF score independently predicted the coronary artery disease (CAD) severity (p< 0.01), one-year mortality (p< 0.01), and MACCEs (p< 0.01). The Global Registry for Acute Coronary Events (GRACE) risk score (GRS 1.0) independently predicted the CAD severity (p< 0.01), whereas the revised GRACE 2.0 risk score (GRS 2.0) independently predicted the one-year mortality (p< 0.01) and MACCEs (p< 0.01). The diagnostic performance of CHA 2 DS 2 -VASc-HSF was similar to GRS 2.0 in predicting the one-year mortality and MACCEs [area under the curve (AUC), 0.75 and 0.69 vs. 0.78 and 0.67; p= 0.41, p= 0.38, respectively) and better than GRS 1.0 for the CAD severity (AUC, 0.85 vs. 0.79; p= 0.03). The Kaplan-Meier curves displayed significantly higher one-year mortality and MACCEs in the high-risk group (p< 0.01) compared with the low-risk group (p< 0.01). Conclusion:The predictive accuracy of CHA 2 DS 2 -VASc-HSF is comparable to that of GRS 2.0 in determining the long-term cardiovascular outcomes; thus, it could be considered as a predictive model for patients with NSTE-ACS.

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

“…In another study, 12 the CHA2DS2-VASc-HSF score was more successful in showing no-reflow phenomenon after PCI in patients with acute coronary syndrome compared with the CHADS2 and CHA2DS2-VASc scores. In addition, Kalyoncuoglu et al 13 found that the CHA2DS2-VASc-HSF score better predicted the 1-year cardiovascular outcomes and major adverse cardiac and cerebrovascular events compared with the CHADS2 and CHADS2-VASc scores in patients with NSTEMI.…”