Predictive value of CHA₂DS₂‐VASc score for in‐hospital prognosis of patients with acute ST‐segment elevation myocardial infarction undergoing primary PCI

Background This study aimed to explore the predictive value of CHA 2 DS 2 ‐VASc score for in‐hospital major adverse cardiac events (MACEs) in ST‐elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary artery intervention. Methods A total of 746 STEMI patients were divided into four groups according to CHA 2 DS 2 ‐VASc score (1, 2–3, 4–5, >5). The predictive ability of the CHA 2 DS 2 ‐VASc score for in‐hospital MACE was made. Subgroup analysis was made between gender differences. Results In a multivariate logistic regression analysis model including creatinine, total cholesterol, and left ventricular ejection fraction, CHA 2 DS 2 ‐VASc score was an independent predictor of MACE as a continuous variable (adjusted odds ratio: 1.43, 95% confidence interval [CI]: 1.27–1.62, p < .001). As a category variable, using the lowest CHA 2 DS 2 ‐VASc score of 1 as a reference, CHA 2 DS 2 ‐VASc score 2–3, 4–5, >5 groups for predicting MACE was 4.62 (95% CI: 1.94–11.00, p = .001), 7.74 (95% CI: 3.18–18.89, p < .001), and 11.71 (95% CI: 4.14–33.15, p < .001). The CHA 2 DS 2 ‐VASc score was also an independent risk factor for MACE in the male group, either as a continuous variable or category variable. However, CHA 2 DS 2 ‐VASc score was not a predictor of MACE in the female group. The area under the curve value of the CHA 2 DS 2 ‐VASc score for predicting MACE was 0.661 in total patients (74.1% sensitivity and 50.4% specificity [ p < .001]), 0.714 in the male group (69.4% sensitivity and 63.1% specificity [ p < .001]), but there was no statistical significance in the female group. Conclusions CHA 2 DS 2 ‐VASc score could be considered as a potential predictor of in‐hospital MACE with STEMI, especially in males.