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. 2017 Nov;33(6):598-604.
doi: 10.6515/ACS20170723A.

The Value of CHA2DS2VASC Score in Predicting All-Cause Mortality in Patients with ST-Segment Elevation Myocardial Infarction Who Have Undergone Primary Percutaneous Coronary Intervention

Kudret Keskin  1 , Süleyman Sezai Yıldız  1 , Gökhan Çetinkal  1 , Gökhan Aksan  1 , Hakan Kilci  1 , Şükrü Çetin  1 , Serhat Sığırcı  1 , Kadriye Kılıçkesmez  1
Affiliations

The Value of CHA2DS2VASC Score in Predicting All-Cause Mortality in Patients with ST-Segment Elevation Myocardial Infarction Who Have Undergone Primary Percutaneous Coronary Intervention

Kudret Keskin et al. Acta Cardiol Sin. 2017 Nov.

Abstract

Background: Acute coronary syndrome is the most common cause of cardiac morbidity and death. Various scoring systems have been developed in order to identify patients who are at risk for adverse outcome and may benefit from more aggressive and effective therapies.

Objectives: This study was designed to evaluate the CHA2DS2VASC score as a predictor of mortality inpatients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention (p-PCI).

Methods: We evaluated 300 patients diagnosed with ST-elevation myocardial infarction who underwent p-PCI and calculated their CHA2DS2VASC scores. According to their CHA2DS2VASC scores, patients were divided into three groups. Group 1: 0-1 points (n = 101), Group 2: 2-3 points (n = 129), and Group 3: 4-9 points (n = 70). The mean, median and minimum duration of follow-up were 21.7 ± 9.4, 21, and 12 months, respectively. All-cause mortality was defined as the primary endpoint of the study.

Results: All-cause mortality was 4% in Group 1, 8.5% in Group 2 and 27.1% in Group 3 respectively. Kaplan-Meier analysis showed that Group 3 (CHA2DS2VASC ≥ 4) had a significantly higher incidence of death [p (log-rank) < 0.001]. In ROC analysis, AUC values for in hospital, 12-month and long-term mortality were 0.88 (0.77-0.99 95% CI), 0.82 (0.73-0.92 95% CI) and 0.79 (0.69-0.88 95% CI), respectively.

Conclusions: CHA2DS2VASC score can be used for predicting both in-hospital, 12-month and long-term mortality in patients with STEMI who have undergone p-PCI.

Keywords: CHA2DS2VASC score; Primary percutaneous coronary intervention; ST segment elevation myocardial infarction.

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Figures

Figure 1
Figure 1
Rates of in-hospital, 12-month and long-term mortality according to the CHA2DS2VASC score.
Figure 2
Figure 2
Kaplan-Meier curves for 12-month mortality.
Figure 3
Figure 3
Kaplan-Meier curves for all-cause mortality in long-term follow-up.
Figure 4
Figure 4
ROC curves comparing CHA2DS2VASC, TIMI STEMI and GRACE ACS risk scores for in-hospital, 12-month and long-term mortality.
See this image and copyright information in PMC

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