Predictive value of newly defined CHA2DS2-VASc-HSF score for severity of coronary artery disease in ST segment elevation myocardial infarction

Abstract

A b s t r a c tBackground: CHADS 2 and CHA 2 DS 2 -VASc scores are widely used in clinical practice and include similar risk factors for the development of coronary artery disease (CAD). It is known that the factors comprising the newly defined CHA 2 DS 2 -VASc-HSF score promote atherosclerosis and are associated with severity of CAD. Aim:To investigate the association of the CHA 2 DS 2 -VASc-HSF score with the severity of CAD as assessed by SYNTAX score (SxS) in patients with ST segment elevation myocardial infarction (STEMI).Methods: A total of 454 consecutive patients with STEMI (males 79%, mean age 57.3 ± 12.9 years), who underwent primary percutaneous coronary intervention were included in our study. The patients were divided into three groups according to the SxS tertiles: low SxS group (SxS < 14; 151 patients), intermediate SxS group (SxS 14-20; 152 patients), and high SxS group (SxS ≥ 21; 151 patients). Results:The CHADS 2 , CHA 2 DS 2 -VASc, and CHA 2 DS 2 VASc-HSF scores were found to be significantly different among the SxS groups (p < 0.001, p < 0.001, and p < 0.001). After multivariate analysis, the CHA 2 DS 2 -VASc-HSF score was associated with high SxS (odds ratio [OR] 1.258, 95% confidence interval [CI] 1.026-1.544; p = 0.028) together with age (OR 1.032, 95% CI 1.013-1.050; p = 0.001) and ejection fraction (OR 0.927, 95% CI 0.901-0.955; p < 0.001). Conclusions:A newly diagnosed CHA 2 DS 2 -VASc-HSF score predicts the severity of atherosclerosis in patients with STEMI.

Evaluation of the Predictive Value of CHA2DS2-VASc Score for In-Stent Restenosis

“…1 Several studies have been conducted to identify the reasons for ISR, and it was shown that clinical, lesion-related, procedural factors and patient-related factors are responsible for ISR. 2 –4 Besides procedural problems related to percutaneous coronary intervention (PCI), chronic conditions related to increased inflammation such as heart failure, diabetes, hypertension, and stroke are also significant risk factors for ISR. 5,6…”

CHA2DS2-Vasc score and CHA2DS2-Vasc-HS score are poor predictors of in-stent restenosis among patients with coronary drug-eluting stents

“…1,16 The CHA 2 DS 2 -VASc score is a stroke risk assessment tool that was derived from and validated in patients with AF. 7,8 This score has been proved to be more sensitive than the CHADS 2 score. 17 Several recent studies have shown that the CHA 2 DS 2 -VASc score can predict undesirable events in those with stable CAD, 18 ACS, 17,19,20 sick sinus syndrome, 21 heart failure, 22 and patients with Takotsubo syndrome, 9 in whom the stent has extended beyond its initial use.…”

“…6 Investigators have reported that both CHADS 2 and CHA 2 DS 2 -VASc scores were related to mortality in individuals that had both stable coronary angina and acute coronary syndrome (ACS). 7,8 A previous study used CHADS 2 and CHA 2 DS 2 -VASc scores to predict coronary artery disease (CAD) severity. 7 The authors concluded that CHADS 2 and CHA 2 DS 2 -VASc scores positively correlated with the number of diseased vessels present ( r = 0.406, r = 0.308, respectively), as well as with the Gensini score ( r = 0.383, r = 0.300, respectively).…”

Role of CHA2DS2-VASc-HS Score as Predictor for Failed Reperfusion After Fibrinolytic in St-Elevation Myocardial Infarction

“…19 A high CHA 2 DS 2 -VASc-HS score is estimated to be able to describe increased thrombogenicity and the number of thrombus in STEMI patients and can produce worse outcome. 20,21 CHA 2 DS 2 -VASc-HS score ≥ 4 is considered to be the optimal value in predicting reperfusion failure based on the ROC curve with a sensitivity of 91.7% and specificity of 69.2%. The study subjects in the group with CHA 2 DS 2 -VASc-HS score ≥ 4 had a higher rate of reperfusion failure compared to the group with CHA2DS2-VASc-HS < 4 which was 33 people (91.7%) compared to 3 people (8.3%).…”