Predictive Value of CHA₂DS₂ -VASc-HSF Score for Severity of Acute Coronary Syndrome

Abstract

CHADS2 and CHA2DS2-VASc scores have been used to assess the prognostic risk of thromboembolism in non-valvular atrial fibrillation patients. Recent studies have shown the utility of CHADS2 and CHA2DS2-VASc scores for evaluating the severity of coronary artery disease (CAD). The newly defined CHA2DS2-VASc-HSF score evaluates atherosclerosis and is associated with CAD severity. This study investigated the association between the CHA2DS2-VASc-HSF score and acute coronary syndrome (ACS) severity as assessed by the Gensini score and the number of vessels. Furthermore, this study also compared the diagnostic value of the CHADS2, CHA2 DS2-VASc, and CHA2DS2-VASc-HSF score for ACS. A total of 2367 eligible inpatients (ACS group [ n = 2030]; non-CAD group [ n = 337]) were consecutively enrolled in this study. Receiver operating characteristic curve diagnostic tests and logistic regression models were used to analyze the risk factors for ACS. The CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF scores were significantly higher in the ACS group than those in the control group. After adjusting for numerous traditional CAD risk factors, an increased CHA2DS2-VASc-HSF score was found to be an independent risk factor for patients with ACS (odds ratio 1.401, 95% confidence interval 1.044, −1.879; P < 0.05). A newly diagnosed CHA2DS2-VASc-HSF score predicts the severity of ACS.

Comparison of Novel Risk Score CHA2DS2-VASc-HSF to CHADS2and CHA2DS2-VASc Scores to Predict the Risk of Severe Coronary Artery Disease

“…A notably higher incidence of previous MI in the ACS group was proved. Family history of CAD showed no significant differences between the two groups [12] .…”

“…In the study done on 2022 [12] , triglyceride levels were significantly higher in the ACS group compared to the Control group, while HDL-C levels were notably lower in the ACS group. Additionally, LDL-C levels were significantly elevated in the ACS group.…”

“…In a study done 2022 [12] , a significantly higher systolic blood pressure in the ACS group compared to the control group, with a notable difference. Diastolic blood pressure did not significantly differ between the two groups.…”

“…Similarly, scientists [12] studied the association between the CHA2DS2-VASc-HSF score and ACS severity using the Gensini score. They also compared the diagnostic value of various scores for ACS.…”

Coronary artery disease severity and risk stratification of patients with non ST-elevation acute coronary syndrome using CHA2DS2-VASc-HSF score

“…Similar results were reported by another study conducted on ST-elevation ACS patients that showed CHA 2 DS 2 -VASc-HSF score were positively correlated with high SS and the cut-off value CHA 2 DS 2 -VASc-HSF score was ≥ 4 with 84.4% sensitivity and 81.9% specificity (AUC 0.83, 95% CI 0.746–0.915, p < 0.001) [ 19 ]. Another study demonstrated that CHA 2 DS 2 -VASc-HSF score was an independent risk factor for high Gensini score and multivessel CAD in patients with ACS including unstable angina, non-ST-elevation myocardial infarction (NSTEMI), or STEMI [ 20 ]. These results are in agreement with the results of our study but the main difference was that our study was conducted on NSTE-ACS patients and using SS to assess the severity of CAD.…”