31st European Heart and Heart Failure Congress
Mansoura Specialized Medical Hospital (MSMH), Cardiology Department, Mansoura, Egypt
Title: Study of the CHA2DS2-VASc score in acute coronary syndrome
Biography: Ahmed Alhaithami
Background: To predict outcomes, acute coronary syndrome (ACS) can be assessed using GRACE and TIMI risk scores, whereas SYNTAX score is used to assess coronary artery disease (CAD) severity and clarify the management. CHA2DS2-VASc score is used as a predictive tool for stroke prevention in non-valvular atrial fibrillation, and it was studied in ACS in terms of outcome and CAD severity.
Methods: Between December 2016 and June 2017, 125 ACS patients (mean age: 57.78 (±9.5) years, 78.4% males) were enrolled in this observational prospective study at Mansoura specialized hospital. 89 patients had been followed-up for six months. Patients were assessed based on history, clinical examination, 12-lead ECG, and coronary angiography.
Results: CHA2DS2-VASc score was significantly correlated with SYNTAX and Gensini scores (p<0.001 and p<0.001, respectively). Receiver operating characteristic (ROC) curves were generated and cutoff values determined for the CHA2DS2-VASc score (cutoff>2; 76% sensitivity; 76.8% specificity; p<0.001) in predicting coronary multivessel disease. Patients with a CHA2DS2-VASc score ≥ 2 had higher in-hospital complications (all p<0.05).
CHA2DS2-VASc score was significantly correlated with in-hospital (11.9%, p=0.21) and six month-mortality (25%, p=0.042). ROC curves were generated and cutoff values determined for the CHA2DS2-VASc score (cutoff>2; 88% sensitivity; 65.3% specificity; p<0.001) in predicting six-month-mortality. Multivariate logistic regression analysis showed that CHA2DS2-VASc score (p<0.001 with odds ratio 2.28; 95% CI 1.47–3.53) was like Grace score a predictor of six-month-mortality.
Conclusion: CHA2DS2-VASc score is associated with increased CAD severity and in-hospital and six-month outcomes.
Keywords: CHA2DS2-VASc score, acute coronary syndrome, coronary artery disease, clinical outcome, Risk Assessment