Key result
R2CHADS2-based scores linked to ~121% higher in-hospital mortality in STEMI patients undergoing p-PCI.
Why the study?
In-hospital mortality remains considerable in STEMI, and assessing mortality risk using R2CHADS2, R2CHA2DS2-VASc, and R2CHA2DS2-VA scores may help predict disease course.
Do R2CHADS2, R2CHA2DS2-VASc, and R2CHA2DS2-VA scores predict in-hospital mortality in STEMI patients undergoing primary PCI?
Observational (n=857)
No
Do R2CHADS2, R2CHA2DS2-VASc, and R2CHA2DS2-VA scores predict in-hospital mortality in STEMI patients undergoing primary PCI?
Effect estimate: OR 2.21 (95% CI 1.38-3.54)
p-value: p=0.001
R2CHADS2, R2CHA2DS2-VASc, and R2CHA2DS2-VA scores are strong independent predictors of in-hospital mortality in STEMI patients undergoing primary PCI.
May support risk stratification in STEMI; leaves open prospective validation before clinical adoption.
Background/Objectives: Despite the contemporary management of ST segment elevation myocardial infarction (STEMI) patients, in-hospital mortality rates remain considerable. Therefore, the assessment of in-hospital mortality risk of patients with STEMI has a major role in terms of disease course. R2CHADS2, R2CHA2DS2-VASc, and R2CHA2DS2-VA scores are potential candidate for the prediction of in-hospital mortality in STEMI patients. This study aims to determine the association between R2CHADS2, R2CHA2DS2-VASc, and R2CHA2DS2-VA scores and in-hospital mortality in patients with STEMI who have undergone primary percutaneous coronary intervention (p-PCI). Methods: A total of 857 consecutive patients diagnosed with STEMI who were admitted to our hospital and treated with p-PCI were included in our study. Results: The mean age of the study population was 58 ± 11 years and the population was predominantly male (78.5%). Patients in the in-hospital mortality group tended to be older compared to those who survived (65 ± 12 and 57 ± 11 years, respectively, p < 0.001), while gender showed no significant difference. Multivariable regression models showed that left ventricular ejection fraction, eGFR, R2CHADS2 (OR 2.21, 95% CI 1.38–3.54, p = 0.001), R2CHA2DS2-VASc (OR 1.91, 95% CI 1.30–2.80, p = 0.001), and R2CHA2DS2-VA (OR 1.97, 95% CI 1.345–2.910, p = 0.001) scores were independent predictors of in-hospital mortality. Conclusions: The R2CHADS2, R2CHA2DS2-VASc, and R2CHA2DS2-VA scores demonstrate strong predictive ability for in-hospital mortality in STEMI patients, and their non-negligible advantages support their implementation in clinical practice.
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Akdeniz et al. (2025) conducted an observational in ST-Elevation Myocardial Infarction (STEMI) (n=857). R2CHADS2, R2CHA2DS2-VASc, and R2CHA2DS2-VA scores was evaluated on In-hospital mortality (OR 2.21, 95% CI 1.38-3.54, p=0.001). R2CHADS2, R2CHA2DS2-VASc, and R2CHA2DS2-VA scores independently predicted in-hospital mortality in STEMI patients undergoing p-PCI (e.g., R2CHADS2 OR 2.21; 95% CI 1.38-3.54; p=0.001).
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