Should we incorporate obstructive sleep apnea in CHA2DS2-VASc score?

Goudis, Christos A.; Daios, Stylianos; Korantzopoulos, Panagiotis; Liu, Tong

doi:10.1007/s11325-021-02305-3

Cited by 1 publication

(2 citation statements)

References 19 publications

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“…The optimal cutoff point of CHA 2 DS 2 -VASc was 3 and MCHA 2 DS 2 -VASc was 8 for predicting the incidence of recurrent MI, which was determined by receiver operating characteristic (ROC) curve, area under the curve (AUC) analysis, and Youden index. Patients were subsequently categorized into the low-risk group (0-2) and high-risk group (3)(4)(5)(6)(7)(8)(9) according to the CHA 2 DS 2 -VASc and low-risk group (0-7) and high-risk group (8)(9)(10)(11)(12)(13)(14)(15) according to the MCHA 2 DS 2 -VASc.…”

Section: Definitions and Outcome Measuresmentioning

confidence: 99%

“…Many clinical stroke risk factors (e.g., obstructive sleep apnea, left atrium dilatation, and renal impairment) ( 6 – 8 ) as well as some biomarkers (e.g., troponin, natriuretic peptides, and von Willebrand factor) ( 9 , 10 ) are closely related to the stroke risk, but they do not improve the predictive value of CHA 2 DS 2 -VASc score. Moreover, patients with MI seem to be at increased risk for recurrent major adverse cardiovascular events (MACEs), owing to their clinical characteristics, comorbidities, and biomarkers, such as elderly (especially older women) ( 11 ), diabetes mellitus (DM), heart failure (HF), renal dysfunction ( 12 ), and interleukin-1beta ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

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CHA2DS2-VASc score for in-hospital recurrence risk stratification in patients with myocardial infarction

Hui

Zhu

Cheang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundUsing the CHA2DS2-VASc score to recognize the risk of stroke in patients with atrial fibrillation has been well-established. However, few studies have assessed whether the CHA2DS2-VASc score has a similar predictive value in recurrence after myocardial infarction (MI).MethodsWe conducted a retrospective observational cohort study of adult inpatients with MI. The CHA2DS2-VASc and modified CHA2DS2-VASc (MCHA2DS2-VASc) scores of all patients were calculated. The associations of both scores with recurrent MI were analyzed.ResultsA total of 6,700 patients with MI (60.0 ± 11.1 years, 77.2% men) were enrolled, and 759 (11.3%) presented a definite recurrence during hospitalization. After multivariable adjustment by logistic regression in patients with MI, the CHA2DS2-VASc and MCHA2DS2-VASc scores were independently associated with recurrence. The MCHA2DS2-VASc score showed a better predictive value for risk of recurrence than that of CHA2DS2-VASc in overall [area under the receiver operating characteristic curve (AUC) 0.757 vs. 0.676] or male patients (AUC 0.759 vs. 0.708). MCHA2DS2-VASc was superior to CHA2DS2-VASc for identifying “truly high-risk” patients with MI, regardless of overall patients or sex-specific subgroups. The two scores had a similar focus on the identification of “low-risk” patients in overall or women, but not in men.ConclusionThe CHA2DS2-VASc and MCHA2DS2-VASc scores for predicting recurrence are validated in patients with MI. However, MCHA2DS2-VASc could be more helpful to secondary prevention than CHA2DS2-VASc after MI, especially in men. The superiority of MCHA2DS2-VASc compared with CHA2DS2-VASc in women is just more discriminatory for “truly high-risk” patients.

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