Usefulness of the CHA2DS2-VASC Score to Predict Adverse Outcomes in Patients Having Percutaneous Coronary Intervention

Orvin, Katia; Bental, Tamir; Assali, Abid; Lev, Eli I.; Vaknin‐Assa, Hana; Kornowski, Ran

doi:10.1016/j.amjcard.2016.02.010

Cited by 33 publications

(25 citation statements)

References 23 publications

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“…A recent study has shown that the CHA 2 DS 2 -VASc score is associated with adverse events in acute coronary syndrome patients [20]. A study by Orvin et al [21] reported that the CHA 2 DS 2 -VASC score predicted all-cause mortality and death or nonfatal MI in a significant and linear manner.…”

Section: Discussionmentioning

confidence: 98%

Importance and usage of the CHA2DS2-VASc score in predicting acute stent thrombosis

Ünal¹,

Açar²,

Yayla³

et al. 2016

Coronary Artery Disease

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Section: Discussionmentioning

confidence: 98%

Importance and usage of the CHA2DS2-VASc score in predicting acute stent thrombosis

Ünal¹,

Açar²,

Yayla³

et al. 2016

Coronary Artery Disease

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“…An ACS subgroup (n = 7729) analysis of a recent study that included 12,785 patients with PCI showed that the CHA 2 DS 2 -VASc score predicted all-cause mortality and death or nonfatal MI in a significant ( P < .001) and graded manner. [ 38 ] Similarly, a study including 1729 consecutive patients with ACS undergoing PCI also demonstrated that CHA 2 DS 2 -VASc score was an independent predictor of adverse events including cardiac death, MI, stroke and any urgent coronary revascularization at long-term follow-up. [ 16 ] Unfortunately, our study did not demonstrate an independent association between CHADS 2 score and MACE.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of CHADS2 and CHA2DS2-VASc scores for post-discharge outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Shao

Dong

et al. 2020

Medicine

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The CHADS 2 and CHA 2 DS 2 -VASc scores were initially developed to assess the risk of stroke or systemic embolism in patients with atrial fibrillation (AF). Recently, these two scoring systems have been demonstrated to predict long- and short-term cardiovascular (CV) outcomes in many patient cohorts. However, to the best of our knowledge, their prognostic value has not been fully elucidated in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). This study aimed to investigate the association of CHADS 2 and CHA 2 DS 2 -VASc scores with CV outcomes in such patients. We included a total of 915 ACS patients undergoing PCI in this study. CHADS 2 and CHA 2 DS 2 -VASc scores were calculated from data collected before discharge. The primary endpoint was defined as a composite of major adverse CV events (MACE) including overall death, nonfatal stroke, nonfatal myocardial infarction (MI) and unplanned repeat revascularization. We assessed MACE's relationship to CHADS 2 and CHA 2 DS 2 -VASc scores using Cox proportional-hazard regression analyses. Mean follow-up duration was 918 days. MACE occurred in 167 (18.3%) patients. A higher CHADS 2 score was associated with reduced event-free survival (EFS) from MACE (logrank test, P = .007) with differences potentiated if stratified by CHA 2 DS 2 -VASc score (logrank test, P < .001). Univariate analysis showed that both CHADS 2 and CHA 2 DS 2 -VASc scores were good predictors of MACE. In the multivariate Cox proportional-hazard regression analysis, CHA 2 DS 2 -VASc score (hazard ratio [HR], 1.15; 95% confidence interval [CI] 1.04–1.27; P = .007) remained a useful predictor of MACE; however, CHADS 2 score was no longer associated with increased risk of MACE. C-statistics for CHA 2 DS 2 -VASc score, GRACE (Global Registry of Acute Coronary Events) hospital discharge risk score (GRACE Score) and SYNTAX (Synergy between PCI with TAXUS and Cardiac Surgery) Score II (SS II) in predicting MACE were 0.614, 0.598, and 0.609, respectively. CHA 2 DS 2 -VASc score was an independent and significant predictor of MACE in ACS patients undergoing PCI, and its discriminatory performance was not inferior to those of GRACE Score and SS II.

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“…7 CHA 2 DS 2 -VASc score was also widely used to predict severity and outcome of coronary artery disease with or without AF. [14][15][16] CHA 2 DS 2 -VASc score has also been applied in PE. A total of 73,541 adults with AF and without PE were followed-up for 1 year.…”

Section: Discussionmentioning

confidence: 99%

Risk Stratification for Acute Pulmonary Embolism in Patients with Atrial Fibrillation: Role of CHADS2 Score

Tang

Avula

et al. 2017

Semin Thromb Hemost

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Pulmonary embolism (PE) is associated with atrial fibrillation (AF). This study sought to explore if the CHADS2 score could predict the prognosis of PE in patients with AF. In a tertiary hospital, 4,288 consecutive patients with diagnosis of PE were screened. In total, 305 patients with PE had AF and were included in this retrospective study. In-hospital outcome was defined as at least one of the following: death from any cause, need for intravenous catecholamine administration, endotracheal intubation, cardiopulmonary resuscitation, or thrombolytic therapy. The in-hospital outcome occurred in 10.2% of the patients. Patients with adverse outcome had higher CHADS2 score, CHA2DS2-VASc score, and simplified pulmonary embolism severity index (sPESI) score. The area under the receiver operating characteristics curve was 0.66, 0.62, and 0.71 for CHADS2 score, CHA2DS2-VASc score, and sPESI score, respectively, in predicting in-hospital outcome. The incidence of in-hospital outcome was 3.4 and 14.4% in sPESI = 0 and sPESI ≥1 groups (p < 0.01). CHADS2 also had good predictive value with the incidence of in-hospital outcome, being 4.6% in CHADS2 < 2 and 14.3% in CHADS2 ≥ 2 groups (p < 0.01). The incidences of in-hospital outcome were 2.6, 4.8, 7.4, and 17.3% in patients with sPESI = 0 and CHADS2 < 2, sPESI = 0 and CHADS2 ≥ 2, sPESI ≥ 1 and CHADS2 < 2, and sPESI ≥ 1 and CHADS2 ≥ 2 (p < 0.01), respectively. In multivariable analysis, CHADS2 (odds ratio: 1.50; 95% confidence interval: 1.11–2.02; p < 0.01) was an independent predictor of in-hospital adverse outcome. High CHADS2 score could predict worse in-hospital outcome in patients with PE and AF.

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Usefulness of the CHA2DS2-VASC Score to Predict Adverse Outcomes in Patients Having Percutaneous Coronary Intervention

Cited by 33 publications

References 23 publications

Importance and usage of the CHA2DS2-VASc score in predicting acute stent thrombosis

Importance and usage of the CHA2DS2-VASc score in predicting acute stent thrombosis

Prognostic value of CHADS2 and CHA2DS2-VASc scores for post-discharge outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Risk Stratification for Acute Pulmonary Embolism in Patients with Atrial Fibrillation: Role of CHADS2 Score

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