Key result
High HELT-E2S2 score linked to ~73% higher 5-year MACE risk versus low score.
Why the study?
The HELT-E2S2 score was recently proposed for ischemic stroke risk in Japanese AF patients, but its prognostic value for cardiovascular events among patients undergoing PCI required evaluation.
Does a high HELT-E2S2 score predict major adverse cardiovascular events in patients undergoing percutaneous coronary intervention?
Observational (n=1,608)
Yes
Does a high HELT-E2S2 score predict major adverse cardiovascular events in patients undergoing percutaneous coronary intervention?
The HELT-E2S2 score, originally designed for risk stratification in atrial fibrillation, is a useful prognostic tool for predicting 5-year cardiovascular and bleeding events in patients undergoing PCI.
May support HELT-E2S2 for post-PCI prognostication; extends its AF-derived utility but remains hypothesis-generating.
The HELT-E2S2 score has recently been proposed as a new risk stratification tool for ischemic stroke in Japanese patients with atrial fibrillation (AF). We aimed to evaluate the prognostic value of HELT-E2S2 score for cardiovascular events among patients undergoing percutaneous coronary intervention (PCI). Between August 2012 and July 2013, patients undergoing PCI enrolled in the SHINANO 5-year registry, a prospective, observational multicenter registry, were analyzed for the current study. Primary endpoint was major adverse cardiovascular events (MACE), a composite of all-cause death, myocardial infarction, and ischemic stroke at 5 years. Key secondary endpoint was bleeding events at 5 years. A total of 1608 patients were divided into the low HELT-E2S2 score group (< 2, n = 915) and high HELT-E2S2 score group (≥ 2, n = 693). Major criteria of the HELT-E2S2 score were hypertension (74.7%), elderly age 75–84 years (31.3%), and AF (11.1%). Kaplan–Meier analysis revealed that the high HELT-E2S2 score group had a significantly higher incidence of MACE (33.4% vs. 14.8%, P < 0.001) and bleeding events (12.7% vs. 5.3%, P < 0.001) compared with the low HELT-E2S2 score group. Multivariable analysis demonstrated that the HELT-E2S2 score remained significantly associated with MACE (hazard ratio: 1.73, 95% confidence interval: 1.11–2.69; P = 0.015). The HELT-E2S2 score appears a useful tool for predicting future cardiovascular events in CAD patients undergoing PCI.
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Sunohara et al. (2025) conducted an observational in Coronary artery disease undergoing percutaneous coronary intervention (n=1,608). High HELT-E2S2 score (≥ 2) vs. Low HELT-E2S2 score (< 2) was evaluated on Major adverse cardiovascular events (MACE), a composite of all-cause death, non-fatal myocardial infarction, and non-fatal ischemic stroke at 5 years (HR 1.73, 95% CI 1.11-2.69, p=0.015). A high HELT-E2S2 score (≥ 2) was significantly associated with an increased risk of major adverse cardiovascular events at 5 years compared to a low score (HR 1.73).
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