CHA2DS2-VASc Score Accurately Predicts PCI Outcomes

The following article is part of conference coverage from the 2018 AHA Scientific Sessions in Chicago, Illinois.The Cardiology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in cardiology. Check back for the latest news from AHA 2018.

CHICAGO — In patients with acute coronary syndrome, CHA₂DS₂-VASc scores can be used to accurately and reliably predict mortality and incidence of secondary outcomes related to percutaneous coronary intervention. This research was presented at the Scientific Sessions of the American Heart Association 2018, held November 10-12, 2018, in Chicago, Illinois.

Investigators of this study sought to examine the accuracy of the CHA₂DS₂-VASc model for predicting the risk of adverse events in patients with acute coronary syndrome undergoing percutaneous coronary intervention. The study sample included 253,027 adults diagnosed with acute coronary syndrome from the National Inpatient Sample; participants underwent percutaneous coronary intervention between 2011 and 2014. Using multivariate logistic regression analysis, the investigators estimated the association between CHA₂DS₂-VASc scores and in-hospital mortality, stroke, acute kidney injury, and cardiopulmonary and vascular complications.

The mean CHA₂DS₂-VASc score for the study population was 2.9±1.5; the primary study outcome was in-hospital mortality, which had a rate of 2.5%. Investigators observed that increased incidence of mortality and all secondary outcomes correlated with CHA₂DS₂-VASc scores. The area under the curve for the CHA₂DS₂-VASc score with mortality was 0.579 (95% CI, 0.571-0.586), indicating significant accuracy as a predictive model.

Higher CHA₂DS₂-VASc scores were an independent predictor of mortality (OR, 1.654; 95% CI, 1.601-1.710; P <.001), as well predicting risk for stroke, acute kidney injury, and cardiopulmonary complications. Vascular disease and hypertension were both found to influence mortality; however, gender was not associated with mortality.

In patients with acute coronary syndrome undergoing percutaneous coronary intervention, CHA₂DS₂-VASc score was a significant predictor of adverse outcomes, including in-hospital mortality and cardiopulmonary complications. The investigators suggest that CHA₂DS₂-VASc score is an accurate model for predicting risk in this population.

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Reference

Abugroun A, Hassan A, Gaznabi S, et al. CHA2DS2-VASc score is highly predictive of in-hospital mortality and procedural complications in acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Presented at: AHA 2018; November 10-12, 2018; Chicago, Illinois. Abstract Sa2072/2072.