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Validity of the CHA2DS2VASc score in assessment of prognosis of STEMI patients irrespective of presence of atrial fibrillation A Single-Center Prospective observational study

Research Authors
Salwa R. Dmitry, MD; Shams-Eddin H, MD; Khaled M. El-maghraby, MD; Alaa F. Kaoud MSc.
Research Department
Research Journal
Egyptian Heart Journal
Research Publisher
Elsevier
Research Rank
2
Research Vol
NULL
Research Website
NULL
Research Year
2019
Research_Pages
NULL
Research Abstract

Background: The CHADS2 and CHA2DS2VASc and scoring systems were designed to stratify thromboembolic risk in patients with atrial fibrillation (AF). All the components of CHA2DS2VASc are important risk and prognostic factors for cardiovascular disease. This study evaluates the effectiveness and accuracy of CHA2DS2VASc score as a risk-stratification tool for in hospital and short-term clinical outcome in ST-elevation myocardial infarction (STEMI) patients. Materials and methods: Our study involved 171 patients admitted with STEMI regardless of presence or absence of AF.GRACE, TIMI and CHA2DS2VASc scores were calculated to all patients at hospital admission. Patients were divided into three groups (score0-2, 3-4 and ≥5) according to CHA2DS2VASc RS .The primary end point was major adverse cardiovascular events (MACE) including cardiovascular death, non- fatal myocardial infarction (MI), and stroke during hospital admission at 3 months and 6 months. The area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive ability of each score at different time points. Results: Our six months follow up was completed in all patients. Cumulative incidence of MACE was 29 cases. In chi-square analysis, incidence of MACE was significantly higher in patients with CHA2DS2VASc score ≥5compared to3–4and 0–2 (38.89% vs19.57% vs12.15%, P = 0.01).Death is the most significant complication (p<0.001). Both TIMI score and GRACE RS didn't demonstrate better discrimination than CHA2DS2VASc risk score in predicting in-hospital, 3-month and 6-month MACE. Conclusion: Our study demonstrates that CHA2DS2VASc score is an independent predictor for short-term prognosis in STEMI patients and can be used as a risk-stratification system in STEMI patients irrespective of method of treatment.