CHA2DS2VASC score in sudden death risk evaluation in patients with late postinfarction ventricular tachycardias

Introduction: T he CHA2DS2VASc score is a clinical tool used to determine the risk of stroke in patients with atrial fibrillation. There are literature data that confirm the possibility to apply this score in the cardi-ovascular events prognosis, including sudden cardiac death (SCD).

Objective: To evaluate the clinical significance of CHA2DS2VASc score in death prognosis, including SCD in patients with late post – infarction ventricular tachycardias (VT).

Methods: The study group included 90 patients, mean age 63.8 ± 1.1 years, most of whom were male (90%), who had a documented VT episode not earlier than 6 weeks after acute myocardial infarction (MI) patients with post – infarction ventricular tachycardia (VT). The CHA2DS2VASc score was calculated for all patients and its value was correlated with patient’s death. The duration of surveillance was 20.2 ± 1.8 months.

Results: Sustained ventricular tachycardia was do-cumented in 61.1% of patients, unsustained VT – in 25.6%, ventricular fibrillation – in 13.3% subjects. The time from MI to the VT episode was 47.1 ± 4.5 months. The mean CHA2DS2VASc score in the evaluated group was 3.61 ± 0.1. A score of 2 points was recorded in 11.1% of patients, a score of 3 – in 37.8%, in 51.1% this value was ≥4. In women, the mean score was higher than in men (3.80 ± 0.35 vs. 3.30 ± 0.10). The CHA-2DS2VASc score was also higher among patients with a compromised ejection fraction (≤35%) compared to those with a ejection function, that exceeded 35% (3.67 ± 0.22 vs. 3.30 ± 0.14). During the follow-up the death rate was 23.3%, and it was higher among women (50% vs. 18%). The CHA2DS2VASc score was significantly higher among dead patients vs. survivors (3.80 ± 0.22 vs. 3.30 ± 0.11). The highest score was attested in sub-jects who died suddenly (3.92 ± 0.7). The Kaplan-Me-ier curves demonstrated that during the follow-up the lowest survival rate was in patients with a CHA2DS-2VASc score ≥4 (log-rank=3.7 p 0.05).

Conclusions: The CHA2DS2VASc score could be used in risk assessment and SCD prediction in patients with late post-infarction ventricular tachycardias.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)