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. 2022 Mar 16:9:790193.
doi: 10.3389/fcvm.2022.790193. eCollection 2022.

Predictive Value of the CHA2DS2-VASc Score for Mortality in Hospitalized Acute Coronary Syndrome Patients With Chronic Kidney Disease

Yaxin Wu  1 , Yanxiang Gao  2 , Qing Li  1 , Chao Wu  3   4 , Enmin Xie  5 , Yimin Tu  5 , Ziyu Guo  1 , Zixiang Ye  1 , Peizhao Li  1 , Yike Li  5 , Xiaozhai Yu  5 , Jingyi Ren  2 , Jingang Zheng  1   2
Affiliations

Predictive Value of the CHA2DS2-VASc Score for Mortality in Hospitalized Acute Coronary Syndrome Patients With Chronic Kidney Disease

Yaxin Wu et al. Front Cardiovasc Med. .

Abstract

Background: Chronic kidney disease (CKD) patients have a high prevalence of coronary artery disease and a high risk of cardiovascular events. The present study assessed the value of the CHA2DS2-VASc score for predicting mortality among hospitalized acute coronary syndrome (ACS) patients with CKD.

Methods: This was a retrospective cohort study that included CKD patients who were hospitalized for ACS from January 2015 to May 2020. The CHA2DS2-VASc score for each eligible patient was determined. Patients were stratified into two groups according to CHA2DS2-VASc score: <6 (low) and ≥6 (high). The primary endpoint was all-cause mortality.

Results: A total of 313 eligible patients were included in the study, with a mean CHA2DS2-VASC score of 4.55 ± 1.68. A total of 220 and 93 patients were assigned to the low and high CHA2DS2-VASc score groups, respectively. The most common reason for hospitalization was unstable angina (39.3%), followed by non-ST-elevation myocardial infarction (35.8%) and ST-elevation myocardial infarction (24.9%). A total of 67.7% of the patients (212/313) received coronary reperfusion therapy during hospitalization. The median follow-up time was 23.0 months (interquartile range: 12-38 months). A total of 94 patients (30.0%) died during follow-up. The high score group had a higher mortality rate than the low score group (46.2 vs. 23.2%, respectively; p < 0.001). The cumulative incidence of all-cause death was higher in the high score group than in the low score group (Log-rank test, p < 0.001). Multivariate Cox regression analysis indicated that CHA2DS2-VASc scores were positively associated with all-cause mortality (hazard ratio: 2.02, 95% confidence interval: 1.26-3.27, p < 0.001).

Conclusion: The CHA2DS2-VASc score is an independent predictive factor for all-cause mortality in CKD patients who are hospitalized with ACS. This simple and practical scoring system may be useful for the early identification of patients with a high risk of death.

Keywords: CHA2DS2-VASc score; acute coronary syndrome (ACS); chronic kidney disease; mortality; prognosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for all-cause mortality by CHA2DS2-VASc score.
Figure 2
Figure 2
Predictive value of CHA2DS2-VASC score for all-cause mortality in different subgroups.
See this image and copyright information in PMC

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