Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 21;24(1):263.
doi: 10.1186/s12872-024-03929-5.

Coronary artery disease severity and risk stratification of patients with non ST-elevation acute coronary syndrome using CHA2DS2-VASc-HSF score

Mohamed Aboel-Kassem F Abdelmegid  1 , Mariam Essa Fares Hanna  2 , Salwa R Demitry  3 , Mohamed Aly Hassan Abdelhafez  3
Affiliations

Coronary artery disease severity and risk stratification of patients with non ST-elevation acute coronary syndrome using CHA2DS2-VASc-HSF score

Mohamed Aboel-Kassem F Abdelmegid et al. BMC Cardiovasc Disord. .

Abstract

Background: Risk stratification assessment of patients with non-ST elevation acute coronary syndrome (NSTE ACS) plays an important role in optimal management and defines the patient's prognosis. This study aimed to evaluate the ability of CHA2DS2-VASc-HSF score (comprising of the components of the CHA2DS2-VASc score with a male instead of female sex category, hyperlipidemia, smoking, and family history of coronary artery disease respectively) to predict the severity and complexity of CAD and its efficacy in stratification for major adverse cardiovascular events (MACE) in patients with NSTE ACS without known atrial fibrillation.

Methods: This study included 200 patients (males 72.5%, mean age 55.8 ± 10.1 years) who were admitted with NSTE ACS. CHA2DS2-VASC-HSF score was calculated on admission. Patients were classified into three groups according to their CHA2DS2-VASC-HSF score: low score group (< 2; 29 patients), intermediate score group (2-4; 83 patients), and high score group (≥ 5; 88 patients). Coronary angiography was conducted and the Syntax score (SS) was calculated. Clinical follow-up at 6 months of admission for the development of MACE was recorded.

Results: SS was significantly high in the high CHA2DS2-VASc-HSF score group compared with low and intermediate score groups. CHA2DS2-VASc-HSF score had a significant positive strong correlation with syntax score (r = 0.64, P < 0.001). Smoking, vascular disease, hyperlipidemia, and CHA2DS2-VASc-HSF score were independent predictors of high SS. For the prediction of severe and complex CAD, CHA2DS2-VASc-HSF score had a good predictive power at a cut-off value ≥ 5 with a sensitivity of 86% and specificity of 65%. Hypertension, vascular disease, high SS, and CHA2DS2-VASc-HSF score were independent predictors of MACE. CHA2DS2-VASC-HSF score ≥ 4 was identified as an effective cut-off point for the development of MACE with 94% sensitivity and 70% specificity.

Conclusions: CHA2DS2-VASC-HSF score is proposed to be a simple bedside score that could be used for the prediction of the severity and complexity of CAD as well as a risk stratification tool for the development of MACE in NSTE ACS patients.

Keywords: CHA2DS2-VASc-HSF score; Coronary artery disease; MACE; NSTE ACS; Syntax score.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Correlation between CHA2DS2-VASc-HSF score and Syntax Score
Fig. 2
Fig. 2
ROC curve for prediction of high Syntax score (A) and MACE (B) based on CHA2DS2-VASc-HSF score
Fig. 3
Fig. 3
Kaplan-Meier survival curve for MACE as stratified for CHA2DS2-VASc-HSF score < 4 and ≥ 4
See this image and copyright information in PMC

References

    1. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. European guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) Eur Heart J. 2012;33(13):1635–701. doi: 10.1093/eurheartj/ehs092. - DOI - PubMed
    1. Daida H, Miyauchi K, Ogawa H, Yokoi H, Matsumoto M, Kitakaze M, et al. Management and two-year long-term clinical outcome of acute coronary syndrome in Japan: prevention of atherothrombotic incidents following ischemic coronary attack (PACIFIC) registry. Circ J. 2013;77(4):934–43. doi: 10.1253/circj.cj-13-0174. - DOI - PubMed
    1. Aydınyılmaz F, Özbeyaz NB, Algul E, Gulıyev İ, Şahan HF, Özkaya İbiş A, et al. Factors affecting adequate myocardial perfusion in patients with acute ST-elevation myocardial infarction with successful epicardial flow. Turkish J Clin Lab. 2023;14(2):228–36. doi: 10.18663/tjcl.1205470. - DOI
    1. Aydinyilmaz F, Ozbeyaz NB, Guliyev I, Algul E, Sahan HF, Kalkan K. Effect of Atherogenic Index of plasma on pre-percutaneous coronary intervention Thrombolysis in Myocardial Infarction Flow in patients with ST Elevation myocardial infarction. Angiology. 2023;33197231185204. 10.1177/00033197231185204. - PubMed
    1. Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G, et al. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making. JAMA. 2000;284(7):835–42. doi: 10.1001/jama.284.7.835. - DOI - PubMed

MeSH terms