The CHA2DS2-VASc Risk Score Predicts Total Occlusion in Infarct-Related Arteries in Patients With Non-ST Elevation Myocardial Infarction

Abstract

Early detection of total coronary artery occlusion (TO) in non-ST elevation myocardial infarction (NSTEMI) patients may be beneficial since invasive treatments are initiated more rapidly in appropriate patients. Previous studies have shown that the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age between 65 and 74 years, female gender) score is associated with thrombus burden in acute coronary syndromes. We investigated the association between the CHA2DS2-VASc risk score and TO in patients with NSTEMI who underwent coronary angiography. TIMI (thrombolysis in myocardial infarction) flow 0 was defined as TO and TIMI flow 1-3 was defined as non-total occlusion (non-TO). The NSTEMI patients (n = 400) included were separated into two groups: those with (n = 138) and without (n = 262) TO. We observed that the CHA2DS2-VASc score was higher in the TO group (3.86 ± 2.32 vs 2.15 ± 1.79, P <.001). The Global Registry of Acute Coronary Events (GRACE) score ( P = .002) and the CHA2DS2-VASc score ( P < .001) were also found to be significant independent predictors for total occlusion in multiple regression analysis. A CHA2DS2-VASc score ≥3 had 68.1% sensitivity and 64.0% specificity (area under the curve (AUC): 0.657, 95% CI: 0.585-0.725, P < .001) for predicting TO. The CHA2DS2-VASc score was an effective tool that predicted TO in patients with NSTEMI.

Using latent class analysis to identify clinical features of patients with occlusive myocardial infarction: Preangiogram prediction remains difficult

“…A lower prevalence of diabetes and hypertension has already been described in occlusive MI but unlike our results they also found occlusive MI patients younger and smokers 14 . Conversely, diabetes and hypertension have been found to be independent risk factors for occlusion as part of the CHA2DS2‐VASc scoring system along with previous stroke and vascular disease 15 . Although numbers in the study were low, further research is required to clarify the risk factors for occlusion.…”

“… 14 Conversely, diabetes and hypertension have been found to be independent risk factors for occlusion as part of the CHA2DS2‐VASc scoring system along with previous stroke and vascular disease. 15 Although numbers in the study were low, further research is required to clarify the risk factors for occlusion.…”

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

“…The fact that the CHA2DS2-VASc-HSF score was better at predicting the severity and prognosis of CAD may be associated with involving more cardiovascular risk factors. In the Yasar et al 1 study, the CHA2DS2-VASc score predicted TO with 68.1% sensitivity and 64.0% specificity. However, could the presence of TO be more successfully predicted using the CHADS2-VASc-HSF?…”

“…We read the article entitled ‘The CHA2DS2-VASc Risk Score Predicts Total Occlusion in Infarct-Related Arteries in Patients With Non-ST Elevation Myocardial Infarction’ by Yasar et al 1 with great interest. They reported a significant relationship between total coronary artery occlusion (TO) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years (doubled), diabetes mellitus, previous stroke or transient ischemic attack (doubled), vascular disease, age 65-74 years, female gender) score in patients presenting with non-ST elevation myocardial infraction (NSTEMI).…”

The CHA2DS2-VASc Risk Score Predicts Total Occlusion in Infarct-Related Arteries in Patients With NSTEMI: Reply

“…We thank Sanlıalp et al 1 for their interest in our article. 2 The CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age between 65 and 74 years, female gender) score is a globally accepted scoring method used by the current European and American guidelines. 3,4 The CHA2DS2-VASc score has been investigated in many clinical situations.…”