Predictive value of CHA2DS2‐VASc score for in‐hospital prognosis of patients with acute ST‐segment elevation myocardial infarction undergoing primary PCI

Abstract

AbstractBackgroundThis study aimed to explore the predictive value of CHA2DS2‐VASc score for in‐hospital major adverse cardiac events (MACEs) in ST‐elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary artery intervention.MethodsA total of 746 STEMI patients were divided into four groups according to CHA2DS2‐VASc score (1, 2–3, 4–5, >5). The predictive ability of the CHA2DS2‐VASc score for in‐hospital MACE was made. Subgroup analysis was made between gender differences.ResultsIn a multivariate logistic regression analysis model including creatinine, total cholesterol, and left ventricular ejection fraction, CHA2DS2‐VASc score was an independent predictor of MACE as a continuous variable (adjusted odds ratio: 1.43, 95% confidence interval [CI]: 1.27–1.62, p < .001). As a category variable, using the lowest CHA2DS2‐VASc score of 1 as a reference, CHA2DS2‐VASc score 2–3, 4–5, >5 groups for predicting MACE was 4.62 (95% CI: 1.94–11.00, p = .001), 7.74 (95% CI: 3.18–18.89, p < .001), and 11.71 (95% CI: 4.14–33.15, p < .001). The CHA2DS2‐VASc score was also an independent risk factor for MACE in the male group, either as a continuous variable or category variable. However, CHA2DS2‐VASc score was not a predictor of MACE in the female group. The area under the curve value of the CHA2DS2‐VASc score for predicting MACE was 0.661 in total patients (74.1% sensitivity and 50.4% specificity [p < .001]), 0.714 in the male group (69.4% sensitivity and 63.1% specificity [p < .001]), but there was no statistical significance in the female group.ConclusionsCHA2DS2‐VASc score could be considered as a potential predictor of in‐hospital MACE with STEMI, especially in males.