Arq. Bras. Cardiol. 2022; 119(3): 393-399

The Predictive Value of CHA2DS2-VASc Score on Residual Syntax Score in Patients With ST Segment Elevation Myocardial Infarction

Ali Kemal Kalkan , Serkan Kahraman , Yalcin Avci , Umit Bulut , Recep Gulmez , Ayse Beril Turkyilmaz , Mehmet Erturk

DOI: 10.36660/abc.20210670

This Original Article is referred by the Short Editorial "Atherosclerotic Burden is the Highway to Cardiovascular Events".

Abstract

Background

The CHA₂DS₂-VASc score is associated with adverse clinical outcomes in patients with cardiovascular disease. The residual Syntax score (rSS) is a scoring tool which has prognostic value in patients with ST segment elevation myocardial infarction (STEMI).

Objectives

Our aim in this study is to investigate the predictive value of the CHA₂DS₂-VASc score on rSS in STEMI patients.

Methods

A total of 688 consecutive patients with STEMI undergoing percutaneous coronary intervention were evaluated. Baseline demographic and clinical variables besides the CHA₂DS₂-VASc score were assessed. The patients were divided into two groups; patients with rSS of 8 or below as group 1 (509 patients) and more than 8 as group 2 (179 patients). A p-value < 0.05 was considered statistically significant.

Results

The CHA₂DS₂-VASc score was higher in group 2 [1 (0-2); 1 (1-3), p<0.001] compared to group 1. The incidence of hypertension [151 (29.7%); 73 (40.8%), p=0.006], patients ≥75 years [18 (3.5%); 21 (11.7%), p<0.001], diabetes mellitus [85 (16.7%); 50 (27.9%), p=0.001] and vascular disease [12 (2.4%); 11 (6.1%), p=0.029] were higher in group 2. In multivariate logistic regression analysis, the CHA₂DS₂-VASc score (OR=1.355; 95%CI=1.171-1.568; p<0.001), age ≥75 years [OR=3.218; 95%CI=1.645-6.295; p=0.001] and diabetes mellitus [OR=1.670; 95%CI=1.091-2.557; p=0.018] were independent predictors of high rSS. The receiver-operating characteristic curve analysis demonstrated that the CHA₂DS₂-VASc score had good predictive value for high rSS with a cut-off value of 1.5 (area under curve (AUC): 0.611, 95% confidence interval (CI):0.562-0.659, p<0.001).

Conclusions

The CHA₂DS₂-VASc score has a predictive value on rSS in patients with STEMI. The CHA₂DS₂-VASc score was also an independent predictor of higher rSS.