The Role of CHA₂DS₂‐VASc Score in Predicting Clinical Complications Following Primary Percutaneous Coronary Intervention: A Systematic Review and Meta‐Analysis

Background The CHA₂DS₂‐VASc score was originally developed to assess stroke risk in patients with atrial fibrillation (AF). Recently, it has been explored as a potential tool for predicting adverse cardiovascular outcomes after percutaneous coronary intervention (PCI). However, its effectiveness in this context remains underexplored. Aims This review aims to evaluate the ability of the CHA₂DS₂‐VASc score to predict adverse cardiovascular outcomes in patients undergoing PCI. Methods A systematic review and meta‐analysis were conducted following PRISMA 2020 guidelines. Ten observational studies involving a total of 14,143 patients were included. The primary outcomes were ISR, AST, and MACE. Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random‐effects models. Results Most included studies were observational with varying endpoints, follow‐up periods, and stent technologies, limiting causal inference, subgroup analyses, and introducing potential bias. The pooled analysis showed that higher CHA₂DS₂‐VASc scores were significantly associated with increased risks of ISR (OR: 2.21; 95% CI: 1.75–2.78), AST (OR: 1.99; 95% CI: 1.53–2.60), and MACE (HR: 1.44; 95% CI: 1.22–1.69). Conclusion The CHA₂DS₂‐VASc score shows strong predictive value for ISR, AST, and MACE after PCI. Its simplicity and ease of use make it a practical tool for bedside risk assessment in clinical settings. Future prospective, multicenter studies with patient‐level data are needed to validate the CHA₂DS₂‐VASc score in non‐AF populations.