Key result
The CHA2DS2-VASc score independently predicted graft failure after coronary artery bypass surgery (OR 2.28), with a score >3 predicting failure with 65.4% sensitivity and 74.3% specificity.
Why the study?
Graft patency is a major concern after CABG, and this study evaluated whether the CHA2DS2-VASc score could serve as a simple tool to predict graft failure.
Does the CHA2DS2-VASc score predict graft failure in patients who underwent CABG surgery?
Case-Control (n=280)
No
Does the CHA2DS2-VASc score predict graft failure in patients who underwent CABG surgery?
Odds Ratio: 2.28 (95% CI 1.02–5.09)
p-value: p=0.045
The CHA2DS2-VASc score may serve as a simple, independent predictor of graft failure after CABG surgery.
CHA2DS2-VASc may stratify graft failure risk after CABG; leaves open prospective validation before clinical use.
Background and objective Graft patency is one of the major concerns after coronary artery bypass graft (CABG) surgery. The CHA2DS2-VASc [congestive heart failure, hypertension, age ≥75 years, diabetes mellitus (DM), stroke or transient ischemic attack (TIA), vascular disease, age 65 to 74 years, sex category] score is a tool that was developed to predict the risk of thrombotic events in patients with atrial fibrillation (AF). In this study, we evaluated the use of the CHA2DS2-VASc score as a simple tool for predicting graft failure (GF) among patients who underwent CABG surgery. Methods In this retrospective case-control study, a total of 280 patients were enrolled after applying the exclusion criteria. Angiograms were analyzed by using the QCA software system (Pie Medical Imaging, Maastricht, The Netherlands) for each patient. A graft was described as failed if it had 70% or more stenosis or was completely occluded. Patients were classified into two groups: group one included patients without GF (GF-N) and group two included patients with GF (GF-Y). Thereafter, the CHA2DS2-VASc risk score was calculated for each patient. Results In our cohort, 136 patients had GF (GF-Y group) and 144 patients did not have GF (GF-N group). GF-N and GF-Y patients had their angiography performed 100.31 ± 8.04 and 103.49 ± 8.41 months after CABG, respectively. GF-Y group had a significantly higher rate of DM, hypertension, and heart failure with reduced ejection fraction (HFrEF). GF-Y group had higher CHA2DS2 (GF-N group: 1.47 ± 0.91 vs. GF-Y group: 2.57 ± 1.17, p=0.0001) and CHA2DS2-VASc score (GF-N group: 2.80 ± 1.11 vs. GF-Y group: 4.15 ± 1.25, p=0.0001). Analyses showed that only CHA2DS2-VASc was an independent predictor of GF while other parameters including DM, hypertension, HFrEF, creatinine, and CHADS2 were not found to be independent predictors of GF. A CHA2DS2-VASc score of >3 predicted GF with a sensitivity of 65.44% and a specificity of 74.31%. Conclusions The CHA2DS2-VASc score might be used as a feasible and simple method to predict the risk of GF after CABG surgery.
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Taşbulak et al. (2022) conducted a case-control in Coronary Artery Bypass Graft (CABG) Surgery (n=280). CHA2DS2-VASc score vs. Lower CHA2DS2-VASc score was evaluated on Graft failure (≥70% stenosis or complete occlusion) (OR 2.28, 95% CI 1.02-5.09, p=0.045). The CHA2DS2-VASc score independently predicted graft failure after coronary artery bypass surgery (OR 2.28), with a score >3 predicting failure with 65.4% sensitivity and 74.3% specificity.
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