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. 2015 Feb;65(2):121-7.
doi: 10.1016/j.jjcc.2014.04.011. Epub 2014 Jun 24.

The CHA2DS2VASc score can be used to stratify the prognosis of acute myocardial infarction patients irrespective of presence of atrial fibrillation

Kyung Hwan Kim  1 , Wan Kim  1 , Sun Ho Hwang  2 , Won Yu Kang  1 , Sang Cheol Cho  1 , Weon Kim  3 , Myung Ho Jeong  4 ; Other Korean Working Group in Myocardial Infarction Registry Investigators
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Free article

The CHA2DS2VASc score can be used to stratify the prognosis of acute myocardial infarction patients irrespective of presence of atrial fibrillation

Kyung Hwan Kim et al. J Cardiol. 2015 Feb.
Free article

Abstract

Background: The CHA2DS2VASc score has been used to evaluate the risk of thromboembolic events in atrial fibrillation. However, because all the components of CHA2DS2VASc are important cardiovascular risk factors, we decided to evaluate the effectiveness of CHA2DS2VASc score as a long-term predictor for prognosis in acute myocardial infarction (AMI) patients.

Methods: We enrolled 15,681 AMI patients for the Korean Working Group in Acute Myocardial Infarction (KORMI) consecutively and analyzed retrospectively. We divided the all the patients into four groups according to CHADS2VASc score (Group I: 0-1, n=3317; Group II: 2-3, n=6794; Group III: 4-5, n=4457; Group IV: 6-9, n=1113). The cardiac event was defined as the sum of all-cause mortality and recurrence of myocardial infarction.

Results: As the risk score increased, the incidence of cardiac events was higher at 1, 6, 12, and 24 months. The cardiac event-free survival rate was lower as the risk score increased (Group I vs Group II, p<0.001; Group II vs Group III, p<0.001; Group III vs Group IV, p=0.037). After adjusting confounding variables, the Cox-regression multivariate analysis showed that the CHA2DS2VASc score was an independent predictor for the long-term prognosis in total AMI patients (p<0.001, hazard ratio=1.414 per scale).

Conclusion: The AMI patients with higher CHA2DS2VASc score had worse cardiovascular outcome. Therefore, CHADS2VASc score can be used to stratify AMI patients according to long-term prognosis irrespective of presence of atrial fibrillation.

Keywords: Acute myocardial infarction; CHA(2)DS(2)VASc score; Major adverse cardiac event.

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