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The Association of the CHA2DS2VASc Score with Acute Stent Thrombosis in Patients with an ST Elevation Myocardial Infarction Who Underwent a Primary Percutaneous Coronary Intervention.
Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre 2018 November 19
OBJECTIVE: In this study, we aimed to determine the predictive value of the CHA2DS2VASc score for acute stent thrombosis (ST) in patients with an ST elevation myocardial infarction (STEMI) treated with a primary percutaneous coronary intervention (pPCI).
METHODS: This was a retrospective study conducted among 3,460 consecutive patients with STEMI patients who underwent pPCIs. Acute ST was considered as a definite or confirmed event in the presence of symptoms suggestive of acute coronary syndrome and angiographic confirmation of ST based on the diagnostic guidelines of the Academic Research Consortium. The ST was classified as acute if it developed within 24 h.
RESULTS: The mean CHA2DS2VASc score was 3.29 ± 1.73 in the ST group, whereas it was 2.06 ± 1.14 in the control group (p < 0.001). In multivariable logistic regression analysis, the CHA2DS2VASc score ≥ 4 was independently associated with acute ST (odds ratio [OR]: 1.64, 95% confidence interval [CI]: 1.54-1.71, p < 0.001). In a receiver operating characteristic curve analysis, the best cut-off value for the CHA2DS2VASc score was ≥ 4, with 60% sensitivity and 73% specificity. Of note, patients with a CHA2DS2VASc score of 4 had a 4.3 times higher risk of acute ST compared to those with CHA2DS2VASc score of 1.
CONCLUSIONS: The CHA2DS2VASc score may be a significant independent predictor of acute ST in patients with STEMI treated with a pPCI. Therefore, the CHA2DS2VASc score may be used to assess the risk of acute ST in patients with STEMI following a pPCI. <br>.
METHODS: This was a retrospective study conducted among 3,460 consecutive patients with STEMI patients who underwent pPCIs. Acute ST was considered as a definite or confirmed event in the presence of symptoms suggestive of acute coronary syndrome and angiographic confirmation of ST based on the diagnostic guidelines of the Academic Research Consortium. The ST was classified as acute if it developed within 24 h.
RESULTS: The mean CHA2DS2VASc score was 3.29 ± 1.73 in the ST group, whereas it was 2.06 ± 1.14 in the control group (p < 0.001). In multivariable logistic regression analysis, the CHA2DS2VASc score ≥ 4 was independently associated with acute ST (odds ratio [OR]: 1.64, 95% confidence interval [CI]: 1.54-1.71, p < 0.001). In a receiver operating characteristic curve analysis, the best cut-off value for the CHA2DS2VASc score was ≥ 4, with 60% sensitivity and 73% specificity. Of note, patients with a CHA2DS2VASc score of 4 had a 4.3 times higher risk of acute ST compared to those with CHA2DS2VASc score of 1.
CONCLUSIONS: The CHA2DS2VASc score may be a significant independent predictor of acute ST in patients with STEMI treated with a pPCI. Therefore, the CHA2DS2VASc score may be used to assess the risk of acute ST in patients with STEMI following a pPCI. <br>.
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