Usefulness of the CHA2DS2-VASc Score in Predicting In-Stent Restenosis Among Patients Undergoing Revascularization With Bare-Metal Stents

Abstract

In-stent restenosis (ISR) is a limitation of percutaneous coronary intervention and has been linked to specific clinical and angiographic variables. The aim of the present study was to investigate the predictive value of preprocedural CHA2DS2-VASc score on ISR in patients undergoing revascularization with bare-metal stent (BMS) implantation for stable coronary artery disease or acute coronary syndrome. In the years 2012 to 2014, a total of 358 consecutive patients (mean age: 62.36 + 11.28 years and 62.2% men) who had undergone successful BMS implantation were included in the study. All patients underwent stent implantation at admission to our center and had another coronary angiography performed due to recurrence of the symptoms consistent with myocardial ischemia and/or a stress test indicating ischemia. The patients were divided into 2 groups-ISR (n ¼ 166) and non-ISR (n ¼ 192). Angiographic ISR was defined as narrowing !50% in the stented coronary artery segment at follow-up angiography. The mean CHA2DS2-VASc score was 3.42 + 1.35 (range 1-7). The CHA2DS2-VASc scores and high-sensitivity Creactive protein (hs-CRP) levels were higher in the ISR group compared to the non-ISR group. At multivariable analysis, CHA2DS2-VASc score (odds ratio [OR]: 2.004, 95% confidence interval: 1.361-2.949, P < .001), total stent length (OR: 1.093, P ¼ .001), stent diameter (OR: 0.129, P < .001), and hs-CRP (OR: 1.224, P < .001) emerged as independent risk factors for ISR. In conclusion, preprocedural CHA2DS2-VASc is an easily calculated score that provides an additional level of risk stratification beyond that provided by conventional risk factors. Thus, this score can be used as a simple and effective tool to predict ISR in patients undergoing BMS implantation.

Relationship Between CHA2DS2-VASc Score and Right Ventricular Dysfunction in Patients With Acute Pulmonary Thromboembolism

“…Therefore, the score was matched against the outcomes of several diseases such as atrial fibrillation with pulmonary embolism, chronic obstructive pulmonary disease with or without AF, decreased left ventricular ejection fraction, and coronary artery disease. 12,21-25 In this study, we firstly investigated the association of the CHA2DS2-VASc score with the RVD, clinical subgroups, and in-hospital mortality. In addition to the abovementioned studies, in this study, we found that the CHA2DS2-VASc score was significantly different among the clinical subgroups in patients with acute PTE and determined that the CHA2DS2-VASc score was an independent predictor of the RVD in these patients.…”

CHA2DS2-Vasc score and CHA2DS2-Vasc-HS score are poor predictors of in-stent restenosis among patients with coronary drug-eluting stents

“…Two previous studies reported elevations in the CHA 2 DS 2 -VASc scores in patients in the ISR groups compared with the non-ISR groups. 11,12 Their multivariate logistic regression analyses showed that the CHA 2 DS 2 -VASc score was an independent risk factor for ISR in patients after BMS implantation, and they concluded that the CHA 2 DS 2 -VASc score was a simple effective means of predicting ISR in those patients. 11,12…”

“…This current study demonstrated that the CHA 2 DS 2 -VASc score and the CHA2DS2-Vasc-HS score were not associated with an increased risk of ISR in individuals undergoing revascularization with DES, which is in contrast with the findings of two earlier BMS studies. 11,12…”

“…11,12 The authors concluded that CHA 2 DS 2 -VASc scores were optimal for forecasting ISR in patients implanted with bare-metal stents (BMS). 11,12 However, whether clinicians can use the CHA 2 DS 2 -VASc scores to anticipate ISR in patients after DES implantation has not yet been explored. Thus, the aim of this current study was to assess whether CHA 2 DS 2 -VASc and CHA 2 DS 2 -VASc-HS scores were predictive of ISR in patients undergoing revascularization with DES secondary to CAD or ACS.…”

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

“…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].…”