The prognostic value of CHA2DS2-VASc and GRACE risk scores in patients with ACS

Trantalis, George; Aggeli, Konstantina; Toutouzas, Konstantinos; Synetos, Αndreas; Latsios, George; Drakopoulou, Maria; Penesopoulou, Vasiliki; Patsa, Chrysoula; Tousoulis, Dimitrios

doi:10.1016/j.hjc.2018.03.001

Cited by 10 publications

(3 citation statements)

References 7 publications

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“…Peng et al found that MACE during hospitalization and long-term follow-up increased when the CHA 2 DS 2 -VASc score increased, and the CHA 2 DS 2 -VASc score exhibited independent predictive value for MACE ( 3 ). The other study demonstrated that the predictive value of the CHA2DS2-VASc score for all-cause mortality and cardiovascular mortality is marginally greater than that of the GRACE score ( 23 ). Our investigation demonstrated that R 2 -CHA 2 DS 2 -VASc ≥ 3 is the optimum cut-off value for predicting MACE with a sensitivity of 50% and a specificity of 91.1%.…”

Section: Discussionmentioning

confidence: 89%

New R2-CHA2DS2-VASc score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

Zhang

Hu²,

Ma³

et al. 2022

Front. Cardiovasc. Med.

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AimsEvaluating the prognostic validity of new R2-CHA2DS2-VASc score for no-reflow phenomena and long-term prognosis in patients following primary percutaneous coronary intervention (PCI) with ST-elevation myocardial infarction (STEMI).Materials and methodsFrom January 2017 to December 2018, a total of 401 patients with STEMI were continuously enrolled. According to the cut-off value, the patients were separated into two groups: R2-CHA2DS2-VASc < 3 group (n = 275) and R2-CHA2DS2-VASc ≥ 3 group (n = 126).ResultsWith a sensitivity of 52.6% and a specificity of 73.1%, the optimal cut-off value for predicting no-reflow is R2-CHA2DS2-VASc ≥ 3. R2-CHA2DS2-VASc ≥ 3 as the ideal cut-off value for predicting major adverse cardiovascular events (MACE) with an area under the curve (AUC) of 0.781 [95% Confidence interval (CI): 0.738–0.801, P 0.001], a sensitivity of 50%, and a specificity of 91.1%. The incidence of MACE, death from all causes, and worsening heart failure was greater in the R2-CHA2DS2-VASc ≥ 3 group, although there was no significant difference in the incidence of repeated revascularisation procedures following PCI between the two groups. R2-CHA2DS2-VASc ≥ 3 was also an independent predictor of MACE (hazard ratio = 2.48, 95% confidence interval CI: 1.33–4.62, P = 0.04). Moreover, this score has a greater sensitivity (66.7%) and specificity (88.7%) for predicting the progression of heart failure.ConclusionR2-CHA2DS2-VASc ≥ 3 was independently associated with no-reflow phenomenon and poor clinical outcomes for patients in STEMI after primary PCI.

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Section: Discussionmentioning

confidence: 89%

New R2-CHA2DS2-VASc score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

Zhang

Hu²,

Ma³

et al. 2022

Front. Cardiovasc. Med.

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“…The components of these two scores are associated with atherosclerosis, vascular spasm, and microvascular dysfunction, which overlap the risk factors of NRP [7]. Several recent studies have also shown that the CHA 2 DS 2 -VASc scores are associated with the severity of coronary artery disease, its prognosis, and NRP in patients with acute MI, contrast-induced nephropathy after PPCI for acute coronary syndrome, in-stent restenosis, acute stent thrombosis, mechanical mitral valve thrombosis, and right ventricular dysfunction [8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 98%

New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Zhang

Sun

2020

BMC Cardiovasc Disord

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Background: The no-reflow phenomenon (NRP) is a serious complication of primary percutaneous coronary intervention (PPCI) and is an independent predictor of poor prognosis. We aimed to find a simple but effective risk stratification method for the prediction of NRP. Methods: This retrospective single-center study included 454 consecutive patients diagnosed with acute STsegment elevation myocardial infarction (STEMI) and treated by PPCI, who were admitted to our emergency department between January 2017 and March 2019. The patients were divided according to the post-PPCI thrombolysis in the myocardial infarction flow rate: the NRP group and the control group. The CHADS 2 , CHA 2 DS 2-VASc, and CHA 2 DS 2-VASc-HSF scores were calculated for all the patients in this study, and multivariable regression and receiver operating characteristic curve analyses were conducted to determine the independent predictors of NRP and the predictive value of the three scores. Results: A total of 454 patients were analyzed in this study: 80 in the no-reflow group and 374 in the control group. The incidence of NRP was 17.6%. Creatine kinase-myocardial band, Killip class, stent length, and multivessel disease also independently predicted NRP. The CHA 2 DS 2-VASc-HSF score had a higher predictive value than the other two scores, and a CHA 2 DS 2-VASc-HSF score of ≥4 predicted NRP with a sensitivity of 72.5% and specificity of 66.5% (area under the curve: 0.755, 95% confidence interval [0.702-0.808]). Conclusion: Although the CHADS 2 , CHA 2 DS 2-VASc, and CHA 2 DS 2-VASc-HSF scores can all be used as simple tools to predict NRP, our findings show that the CHA 2 DS 2-VASc-HSF score had the highest predictive value. Thus, the CHA 2 DS 2-VASc-HSF score may be an optimal tool for predicting high-risk patients.

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“…The CHA 2 DS 2 -VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke, vascular disease and sex) score is a simple risk stratification scheme to estimate stroke/thromboembolic risk in patients with nonvalvular atrial fibrillation (AF). 18 Recent studies have reported that the CHA 2 DS 2 -VASc score could predict adverse clinical outcomes in stable coronary artery disease, acute coronary syndrome (ACS), 19 or patients undergoing revascularization, 20,21 independent of the presence of AF. [22][23][24] However, it remains unknown whether this score system has the ability to predict ischemic events in patients who underwent PCI.…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of CHA₂DS₂-VASc Score for Ischemic Events in Patients Undergoing Percutaneous Coronary Intervention

et al. 2018

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We evaluated the association of preprocedure CHA2DS2-VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke, vascular disease, and sex) score with ischemic events in patients undergoing percutaneous coronary intervention (PCI). The Dryad Digital Repository enrolled 2533 patients between July 2009 and August 2011. We recorded 1-year ischemic events. Univariate and multivariable logistic regression analyses were used to analyze the association between CHA2DS2-VASc score and ischemic events. Receiver operating characteristic curves were used to evaluate the accuracy of CHA2DS2-VASc score in predicting long-term ischemic events. Long-term death (9.5 vs 2.8%), cardiac death (2.9 vs 1.4%), and nonfatal stroke (1.9 vs 0.7%) were significantly higher in the CHA2DS2-VASc score ≥2 group than the CHA2DS2-VASc score ≤1 group. The CHA2DS2-VASc score was a predictor for all-cause death (odds ratio [95% confidence interval]: 3.71 [1.89-7.30]). The risk factors for all-cause death in CHA2DS2-VASc score ≥2 patients included age, diagnosis, heart failure, older myocardial infarction, diabetes, and chronic obstructive pulmonary disease, while the risk factor for CHA2DS2-VASc score ≤1 patients was age. In conclusion, the CHA2DS2-VASc score is associated with long-term all-cause death, cardiac death, and stroke in patients undergoing PCI, and it may have a potential use for risk stratification for patients who undergo PCI.

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The prognostic value of CHA2DS2-VASc and GRACE risk scores in patients with ACS

Abstract: In our study, The CHADS-VASc score managed to predict, marginally better, the appearance of MACCE over GRACE, in patients with angioplasty.

Cited by 10 publications

References 7 publications

New R2-CHA2DS2-VASc score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

New R2-CHA2DS2-VASc score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Predictive Value of CHA₂DS₂-VASc Score for Ischemic Events in Patients Undergoing Percutaneous Coronary Intervention

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The prognostic value of CHA2DS2-VASc and GRACE risk scores in patients with ACS

Abstract: In our study, The CHADS-VASc score managed to predict, marginally better, the appearance of MACCE over GRACE, in patients with angioplasty.

Cited by 10 publications

References 7 publications

New R2-CHA2DS2-VASc score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

New R2-CHA2DS2-VASc score predicts no-reflow phenomenon and long-term prognosis in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

New CHA2DS2-VASc-HSF score predicts the no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Predictive Value of CHA2DS2-VASc Score for Ischemic Events in Patients Undergoing Percutaneous Coronary Intervention

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Predictive Value of CHA₂DS₂-VASc Score for Ischemic Events in Patients Undergoing Percutaneous Coronary Intervention