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. 2022 Sep;119(3):393-399.
doi: 10.36660/abc.20210670.

The Predictive Value of CHA2DS2-VASc Score on Residual Syntax Score in Patients With ST Segment Elevation Myocardial Infarction

[Article in English, Portuguese]
Ali Kemal Kalkan  1 , Serkan Kahraman  1 , Yalcin Avci  1 , Umit Bulut  1 , Recep Gulmez  1 , Ayse Beril Turkyilmaz  1 , Mehmet Erturk  1
Affiliations

The Predictive Value of CHA2DS2-VASc Score on Residual Syntax Score in Patients With ST Segment Elevation Myocardial Infarction

[Article in English, Portuguese]
Ali Kemal Kalkan et al. Arq Bras Cardiol. 2022 Sep.

Erratum in

  • Errata.
    [No authors listed] [No authors listed] Arq Bras Cardiol. 2023 Jul 24;120(7):e20230356. doi: 10.36660/abc.20230356. Arq Bras Cardiol. 2023. PMID: 37493652 Free PMC article. English, Portuguese.

Abstract
in English, Portuguese

Background: The CHA2DS2-VASc score is associated with adverse clinical outcomes in patients with cardiovascular disease. The residual Syntax score (rSS) is a scoring tool which has prognostic value in patients with ST segment elevation myocardial infarction (STEMI).

Objectives: Our aim in this study is to investigate the predictive value of the CHA2DS2-VASc score on rSS in STEMI patients.

Methods: A total of 688 consecutive patients with STEMI undergoing percutaneous coronary intervention were evaluated. Baseline demographic and clinical variables besides the CHA2DS2-VASc score were assessed. The patients were divided into two groups; patients with rSS of 8 or below as group 1 (509 patients) and more than 8 as group 2 (179 patients). A p-value < 0.05 was considered statistically significant.

Results: The CHA2DS2-VASc score was higher in group 2 [1 (0-2); 1 (1-3), p<0.001] compared to group 1. The incidence of hypertension [151 (29.7%); 73 (40.8%), p=0.006], patients ≥75 years [18 (3.5%); 21 (11.7%), p<0.001], diabetes mellitus [85 (16.7%); 50 (27.9%), p=0.001] and vascular disease [12 (2.4%); 11 (6.1%), p=0.029] were higher in group 2. In multivariate logistic regression analysis, the CHA2DS2-VASc score (OR=1.355; 95%CI=1.171-1.568; p<0.001), age ≥75 years [OR=3.218; 95%CI=1.645-6.295; p=0.001] and diabetes mellitus [OR=1.670; 95%CI=1.091-2.557; p=0.018] were independent predictors of high rSS. The receiver-operating characteristic curve analysis demonstrated that the CHA2DS2-VASc score had good predictive value for high rSS with a cut-off value of 1.5 (area under curve (AUC): 0.611, 95% confidence interval (CI):0.562-0.659, p<0.001).

Conclusions: The CHA2DS2-VASc score has a predictive value on rSS in patients with STEMI. The CHA2DS2-VASc score was also an independent predictor of higher rSS.

Fundamento: O escore CHA2DS2-VASc está associado a desfechos clínicos adversos em pacientes com doença cardiovascular. O escore Syntax residual (residual Syntax score — rSS) é uma ferramenta de pontuação que tem valor prognóstico em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST (IAMCSST).

Objetivos: Este estudo objetivou investigar o valor preditivo do escore CHA2DS2-VASc para o rSS em pacientes com IAMCSST.

Métodos: Foram avaliados 688 pacientes consecutivos com IAMCSST submetidos à intervenção coronária percutânea. Além do escore CHA2DS2-VASc, variáveis demográficas e clínicas de referência foram analisadas. Os pacientes foram divididos em dois grupos: grupo 1 – indivíduos com rSS até 8 (509 pacientes); grupo 2 – aqueles com rSS acima de 8 (179 pacientes). Valores p<0,05 foram considerados estatisticamente significativos.

Resultados: O escore CHA2DS2-VASc foi maior no grupo 2 [1 (0–2); 1 (1–3), p<0,001] comparado ao grupo 1. A incidência de hipertensão [151 (29,7%); 73 (40,8%), p=0,006], idade ≥75 anos [18 (3,5%); 21 (11,7%), p<0,001], diabetes mellitus [85 (16,7%); 50 (27,9%), p=0,001] e doença vascular [12 (2,4%); 11 (6,1%), p=0,029] foi maior no grupo 2. Na análise de regressão logística multivariada, o escore CHA2DS2-VASc (odds ratio — OR=1,355; intervalo de confiança de 95% — IC95%=1,171–1,568; p<0,001), idade ≥75 anos [OR=3,218; IC95%=1,645–6,295; p=0,001] e diabetes mellitus [OR=1,670; IC95%=1,091–2,557; p=0,018] foram preditores independentes de rSS elevado. A análise da curva receiver-operating characteristic demonstrou o bom valor preditivo do escore CHA2DS2-VASc para rSS elevado com valor de corte de 1,5 (área sob a curva/area under the curve — AUC= 0,611, IC95%=0,562–0,659, p<0,001).

Conclusões: O escore CHA2DS2-VASc tem valor preditivo para rSS em pacientes com IAMCSST. Além disso, o escore CHA2DS2-VASc foi um preditor independente de rSS mais alto.

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Conflict of interest statement

Potencial conflito de interesse

Não há conflito com o presente artigo.

Figures

Figura 1
Figura 1. A) Correlação entre o escore CHA2DS2-VASc e o escore Syntax residual. B) Valor do escore Syntax residual para cada escore CHA2DS2-VASc.
Figure 1
Figure 1. A) Correlation between CHA2DS2-VASc score and residual Syntax score. B) Residual Syntax score value for each CHA2DS2-VASc score.
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Comment in

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