Predicting the Likelihood for Severe CAD and CABG Indication on Elective Patients: Comparison of Novel CHA2DS2-VASc-HSF with CHA2DS2 and CHA2DS2-VASc Score

Abstract

Abstract Abundant scoring systems are available to assess the severity of coronary artery disease (CAD) and its intervention. However, the majority of them require advanced technologies. CHA2DS2-VASc-HSF is a novel and simple risk scoring, easily used for screening in primary care level. We hypothesize that CHA2DS2-VASc-HSF is predictive for severe CAD and indicative for coronary artery bypass grafting (CABG). Additionally, we compared its predictive value with CHA2DS2 and CHA2DS2-VASc score. A total of 210 consecutive patients who underwent elective coronary angiography were enrolled in our study. Anthropometric, laboratory, angiographic findings, and patient history were obtained from medical records and used to calculate CHA2DS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF score. Severe CAD is defined as Gensini Score >20. CABG indication was defined based on Class I recommendation from the American Heart Association (AHA). Statistical analyses were done using SPSS 25.0. Receiver operating characteristic (ROC) curve analysis showed the CHA2DS2 score (AUC [Area Under the Curve], 0.630; 95% CI, 0.555–0.706; p = 0.001), CHA2DS2-VASc score (AUC, 0.680; 95% CI, 0.608–0.752; p=0.000), and CHA2DS2-VASc-HSF score (AUC, 0.785; 95% CI, 0.723–0.846; p=0.000) were predictive of severe CAD. CHA2DS2-VASc-HSF score (AUC, 0.841; 95% CI, 0.711–0.971; p=0.00) were predictive of CABG indication. The CHA2DS2-VASc-HSF score provides the highest predictive value for severe CAD and CABG indication compared to the CHA2DS2 and CHA2DS2-VASc score, suggesting that CHA2DS2-VASc-HSF score may be used in primary care settings to suggest referral for coronary angiography and predict CABG possibilities.