Stroke and death prediction with CHA2DS2-vasc score after myocardial infarction in patients without atrial fibrillation

Podolecki, Tomasz; Lenarczyk, Radosław; Kowalczyk, Jacek; Świerad, Marcin; Świątkowski, Andrzej Marian; Jedrzejczyk, Ewa; Chodór, Piotr; Zielińska, Teresa; Kalarus, Zbigniew

doi:10.2459/jcm.0000000000000241

Cited by 26 publications

(21 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, even an intermediate CHA 2 DS 2 ‐VASc score of 2 to 3 was associated with a significant 2.6‐fold increase in 1‐year mortality. These findings were further supported by several studies of various populations of patients with ACS, regardless of the presence of AF …”

Section: Discussionsupporting

confidence: 71%

“…The CHA 2 DS 2 ‐VASc score (congestive heart failure, hypertension, age > 75 [doubled], diabetes mellitus, previous stroke/TIA [doubled], vascular disease, age 65–74 years, sex category [female]) has been recommended for assessment of thromboembolic risk in patients with atrial fibrillation (AF) . Recent studies have demonstrated its relevance in risk stratification of patients with ACS, regardless of the presence of AF . The aim of the current study was to investigate the correlation between preadmission CHA 2 DS 2 ‐VASc score and adverse clinical outcomes in patients presenting with chest pain and discharged from internal medicine wards following ACS rule‐out.…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

CHA₂DS₂‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out

Topaz

Haisraely

Shacham

et al. 2018

Clinical Cardiology

View full text Add to dashboard Cite

Background Chest‐pain patients deemed safe for discharge from internal medicine wards might still be at risk for adverse outcomes. Hypothesis CHA2DS2‐VASc score improves risk stratification of low‐risk chest‐pain patients discharged after acute coronary syndrome (ACS) rule‐out. Methods We accessed medical records of patients who were admitted to internal medicine wards at a single medical center during 2010–2016 and discharged following an ACS rule‐out. Patients were classified according to CHA2DS2‐VASc score: 0–1 (low), 2–3 (intermediate), >3 (high). Primary endpoint was occurrence of ACS at 1 year; 30‐day and 1‐year all‐cause mortality (ACM) were secondary outcomes. Results Of 12 449 patients, 7057 (57%) had low, 3781 (30%) intermediate, and 1611 (13%) high CHA2DS2‐VASc scores. Compared with a low score, intermediate and high scores were associated with significantly increased risk for 1‐year ACS during the first year (OR: 2.89, 95% CI: 1.91–4.37, P < 0.01 and OR: 4.84, 95% CI: 3.02–7.74, P < 0.01, respectively). Each 1‐point increase in CHA2DS2‐VASc was associated with a 37% increased risk for 1‐year ACS. A higher CHA2DS2‐VASc score was associated with significantly higher 30‐day ACM. Hazard ratios for 30‐day ACM were 1.9 (95% CI: 1.1–3.4, P = 0.03) and 4.4 (95% CI: 2.4–7.9, P < 0.01) for intermediate and high CHA2DS2‐VASc scores, respectively, compared with a low score. Each 1‐point increase in CHA2DS2‐VASc score was associated with 43% increased risk for 30‐day mortality. Conclusions High CHA2DS2‐VASc score (>3) was associated with adverse outcomes among chest‐pain patients discharged from internal medicine wards following ACS rule‐out.

show abstract

Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 98%

CHA₂DS₂‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out

Topaz

Haisraely

Shacham

et al. 2018

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…Based on that modified R-CHA 2 DS 2 -VASc score, a study showed a good calibration and high discriminative performance of that score in the prediction of post-discharge ischemic stroke and all-cause mortality [23]. Recently, Podolecki et al [16] studied 2980 patients with acute coronary syndromes and no AF and reported that an increment of one point in the CHA 2 DS 2 -VASc score was independently associated with a 41 % increase in stroke risk and a 23 % increase in mortality rate ( P < 0.001 for both). Our results agree with the aforementioned studies.…”

Section: Discussionmentioning

confidence: 99%

“…More importantly, CHA 2 DS 2 -VASc score is recognized to be related to mortality and ischemic stroke in patients without AF and stroke [28, 29], heart failure [24], acute coronary syndromes [25], undergoing CABG [30]. Interestingly, Podolecki et al analyzing patients with acute coronary syndromes failed to show any discrimination performance of CHA 2 DS 2 -VASc score in predicting incident MI during follow-up [16]. This finding is in agreement with our observations.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

CHA2DS2-VASc score is useful in predicting poor 12-month outcomes following myocardial infarction in diabetic patients without atrial fibrillation

et al. 2016

View full text Add to dashboard Cite

AimsTIMI risk score and GRACE risk model are widely available and accepted scores for risk assessment in STEMI patients and include predictors of poor outcomes. CHA2DS2-VASc is a validated score for predicting embolic/stroke risk in patients with non-valvular atrial fibrillation. Its components contribute to the worse prognosis following myocardial infarction. The advantage of the CHA2DS2-VASc score in comparison with other risk scores is that it provides a comprehensive, fast, and simple method for physicians in risk evaluation that requires no calculators or computers. Therefore, we have set out to examine the prognostic significance of CHA2DS2-VASc score following STEMI in diabetic patients without AF.MethodsA total of 472 patients with diabetes mellitus and STEMI undergoing primary PCI were enrolled. Based on the estimated CHA2DS2-VASc score, the study population was divided into three groups: group 1 (N = 111) with a moderate CHA2DS2-VASc score of 2 or 3; group 2 (N = 257) with a high CHA2DS2-VASc score of 4 or 5; and group 3 (N = 104) with a very high CHA2DS2-VASc score of 6 or higher.ResultsIn diabetic patients with STEMI, the median of CHA2DS2-VASc score was 4 (interquartile range 3–5). In-hospital mortality rate was similar across three groups. CHA2DS2-VASc score was not a risk factor of in-hospital mortality. ROC analysis revealed good diagnostic value of CHA2DS2-VASc score in predicting long-term mortality (AUC 0.62 95 % CI 0.57–0.66 P = 0.0003) and stroke (AUC 0.75 95 % CI 0.71–0.79 P = 0.0003), but no value in predicting long-term myocardial infarction. CHA2DS2-VASc score was an independent predictor of 12-month mortality and stroke. One-point increment in CHA2DS2-VASc score was associated with an increase in the risk of 12-month death by 24 % and for 12-month stroke by 101 %. ConclusionsIn diabetic patients with STEMI and no previous AF, median CHA2DS2-VASc score was high (4 points) and predicted 12-month death and stroke. However, it failed to predict in-hospital death and 12-month MI. CHA2DS2-VASc score had a similar discrimination performance in predicting 12-month mortality as TIMI risk score and a better discrimination performance in predicting 12-month stroke than TIMI risk score. Thus, it can serve as an additive tool in identifying high-risk patients that require aggressive management.

show abstract

Percutaneous coronary intervention in patients hospitalized for non-ST-elevation myocardial infarction and the risk of postdischarge ischemic stroke at 6-month, 1-year, and 3-year follow-ups

et al. 2019

View full text Add to dashboard Cite

Stroke and death prediction with CHA2DS2-vasc score after myocardial infarction in patients without atrial fibrillation

Abstract: The mortality rate and risk of stroke were strongly associated with the CHA2DS2-VASc scores. Hence, this scoring system could be useful to identify high-risk patients with no history of atrial fibrillation, in whom additional preventive measures might be beneficial to improve the outcome.

Cited by 26 publications

References 29 publications

CHA₂DS₂‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out

CHA₂DS₂‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out

CHA2DS2-VASc score is useful in predicting poor 12-month outcomes following myocardial infarction in diabetic patients without atrial fibrillation

Percutaneous coronary intervention in patients hospitalized for non-ST-elevation myocardial infarction and the risk of postdischarge ischemic stroke at 6-month, 1-year, and 3-year follow-ups

Contact Info

Product

Resources

About

Stroke and death prediction with CHA2DS2-vasc score after myocardial infarction in patients without atrial fibrillation

Abstract: The mortality rate and risk of stroke were strongly associated with the CHA2DS2-VASc scores. Hence, this scoring system could be useful to identify high-risk patients with no history of atrial fibrillation, in whom additional preventive measures might be beneficial to improve the outcome.

Cited by 26 publications

References 29 publications

CHA2DS2‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out

CHA2DS2‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out

CHA2DS2-VASc score is useful in predicting poor 12-month outcomes following myocardial infarction in diabetic patients without atrial fibrillation

Percutaneous coronary intervention in patients hospitalized for non-ST-elevation myocardial infarction and the risk of postdischarge ischemic stroke at 6-month, 1-year, and 3-year follow-ups

Contact Info

Product

Resources

About

CHA₂DS₂‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out

CHA₂DS₂‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out