Is the CHA2DS2-VASc score useful forpredicting complications in patients with ST-segment elevation myocardial infarction?

Introduction: Numerous scores have been developed to assess the risk in ST-segment elevation myocardial infarction (STEMI) patients. However, none of them takes into account preexisting cardiovascular risk factors. The CHA2DS2-VASc score, initially developed for assessing the embolic risk in atrial fibrillation patients, contains several variables known to affect the progno-sis of STEMI patients.

Objective: To evaluate the ability of the CHA2DS2-VASc score to predict complications in STEMI patients.

Methods: All patients who underwent primary per-cutaneous coronary intervention (PCI) for STEMI between 2011 and 2016 in our center were analyzed retrospectively. The CHA2DS2-VASc score was calcu-lated and the data regarding intraprocedural, in-hospi-tal, and long-term complications, including in-hospital and long-term (i.e., 24 months) mortality, was collec-ted.

Results: Of the 661studied patients, 176 (26.6%) pre-sented intraprocedural complications. In-hospital complications occurred in 219 (33.1%) patients. In-ho-spital mortality was 5.5%, whilst long-term mortality was 7.4%.The CHA2DS2-VASc score was significantly higher in patients who developed intraprocedural „no reflow“ (p=0.02)and in-hospital cardiogenic shock (p<0.01), asystole (p=0.0001), and sudden cardiac death (p<0.01). The CHA2DS2-VASc score was also significantly higher in patients who died either during (p<0.0001) or after (p=0.01) hospital stay. Overall, a CHA2DS2-VASc score>2 was associated with a 36% higher risk of either intraprocedural or in-hospital complications, with a 5.3-fold increase in the risk of in-hospital death, and with a 3.6-fold increase in the risk of late death (all p<0.01).

Conclusions: In patients with STEMI treated by pri-mary PCI, the CHA2DS2-VASc score was able to pre-dict several intraprocedural and in-hospital complica-tions, including in-hospital and long-term mortality. Due to its rapidity and easy of use, the CHA2DS2-VASc score could help clinicians in identifying high-risk pa-tients, who would benefit the most from closer follow-up and more stringent prophylaxis.

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)