The Predictive Value of the CHA2DS2-VASc Score for In-Stent Restenosis Among Patients with Drug-Eluting Stents Implantation

Abstract

Objective The CHA2DS2-VASc score, a system which has been initially recommended for the assessment of thromboembolic risk in patients with atrial fibrillation (AF), arouses attention in the field of adverse coronary events. The purpose of this study was to explore the predictive value of preprocedural CHA2DS2-VASc score on ISR in patients after drug-eluting stent (DES) implantation. Methods To further investigate the relationship between CHA2DS2-VASc scores and ISR after DES, a retrospective study of DES was carried on. Additionally, the preoperative variables for the ISR and control groups were contrasted. Predictive factors were chosen using the optimal subset regression. We validate the model using internal validation. The prediction model was evaluated using the receiver operator characteristic (ROC) analysis. Results We used a 3:7 ratio to create an experimental group and a validation group, and then ran a stepwise regression with the data from each of the two groups. The results showed that CHA2DS2-VASc score was an independent risk factor for ISR in both the experimental (p = 0.0139) and validation groups (p = 0.0014), and both had significant predictive value for ISR. The area of the ROC curve was greater than 0.5 in both groups (AUC = 0.78, 0.719, respectively) indicating that the model fit was good in both groups. Conclusion The CHA2DS2-VASc score is a reliable predictor of in-stent restenosis (ISR) after DES implantation.

CHA2DS2-VASc Score, Fibrinogen, and Neutrophil to Lymphocyte Ratio as Predictors of In-Stent Restenosis in Patients with Severe Kidney Disease

“…A higher CHA2DS2-VASc score indicates a greater number of CKD risk factors and an increased susceptibility to ISR. In recent years, numerous studies have demonstrated that the CHA2DS2-VASc score has predictive value for ISR in various patient populations [2,[5][6][7]. Consistently, this research found that the CHA2DS2-VASc score was an independent risk factor for ISR in patients with SKD.…”

“…The most frequently utilized method for PCI is the insertion of a stent, which is associated with potential complications including stent thrombosis and restenosis [5]. As PCI procedures become more complex and involve multi-ple vessels, ISR is becoming more prevalent.…”

“…The CHA2DS2-VASc score is utilized to assess the risk of embolism in patients with atrial fibrillation (AF) based on congestive heart failure (CHF), hypertension, diabetes mellitus, stroke history, vascular disease, and female gender [4]. Recently, several studies have proved that the CHA2DS2-VASc score is predictive of ISR in various patient populations [2,[5][6][7]. Underexpansion or fracture are the primary mechanical factors leading to stent failure, while local inflammation, aggressive neointimal proliferation, late acquired malposition, or neoatherosclerosis are the main biological factors [8].…”