Key result
A high CHA2DS2VASc score was associated with a nearly 5-fold increased odds of 30-day major adverse cardiovascular and cerebrovascular events compared to a low score in patients with STEMI (OR 4.939).
Why the study?
The CHA2DS2VASc score includes risk factors for CAD, and this study investigated whether admission CHA2DS2VASc score predicts in-hospital and 30-day mortality and MACCE in STEMI patients undergoing p-PCI.
Does the CHA2DS2VASc score predict mortality and MACCE in patients with STEMI undergoing primary PCI?
Cohort (n=212)
No
Does the CHA2DS2VASc score predict mortality and MACCE in patients with STEMI undergoing primary PCI?
Odds Ratio: 4.939
Absolute Event Rate: 52.8% vs 3.1%
p-value: p=0.026
The CHA2DS2VASc score calculated at admission is a strong, easily accessible independent predictor of 30-day MACCE and mortality in patients with STEMI undergoing primary PCI.
May aid MACCE risk stratification in STEMI PCI; hypothesis-generating pending prospective validation.
The CHA2DS2VASc score includes risk factors for coronary artery disease. The aim of this study is to show that the CHA2DS2VASc score calculated at the time of hospital admission may predict mortality and major adverse cardiovascular and cerebrovascular events (MACCE) in-hospital and at 30-day follow-up for patients with STEMI, who were subjected to primary percutaneous coronary intervention (p-PCI). A retrospective cohort study was performed at University Hospital Center ‘Mother Teresa’, in the Cardiology Department between June 2021 and September 2021. The CHA2DS2VASc score was calculated at the time of hospital admission for all of them. The study population was divided into 3 groups according to the CHA2DS2VASc score at the time of admission. A statistical control of result of hospital MACCE was done. As the result of multivariable analysis, smoking and CHA2DS2VASc groups were found to be independent MACCE predictors. The chances of developing MACCE were approximately 5 times higher in a patient of the third CHA2DS2VASc group, compared to that of the first group. CHA2DS2VASc groups are important to define the likelihood that MACCE will occur in patients with ascending STEMI who had undergone PCI. The ROC plot provided a visual representation of the accuracy of CHA2DS2VASc in predicting reinfarction and stroke. AUC 0.852 (95% C.I: 0.776-0.928) showed when CHA2DS2VASc has this predictive ability for morbidity and mortality. CHA2DS2VASc ≥ 4 can be used to determine risk of reinfarction and stroke.
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Beliu et al. (2022) conducted a cohort in ST-elevated myocardial infarction (STEMI) (n=212). High CHA2DS2VASc score (5-9 points) vs. Low CHA2DS2VASc score (1-2 points) was evaluated on Major adverse cardiovascular and cerebrovascular events (MACCE) at 30 days (OR 4.939, p=0.026). A high CHA2DS2VASc score was associated with a nearly 5-fold increased odds of 30-day major adverse cardiovascular and cerebrovascular events compared to a low score in patients with STEMI (OR 4.939).
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