P843Study of the CHA2DS2-VASc score in acute coronary syndrome

Abstract

Abstract Background To predict outcomes, acute coronary syndrome (ACS) can be assessed using GRACE and TIMI risk scores, whereas SYNTAX score is used to assess coronary artery disease (CAD) severity and clarify the management. CHA2DS2-VASc score is used as a predictive tool for stroke prevention in non-valvular atrial fibrillation, and it was studied in ACS in terms of outcome and CAD severity Methods Between December 2016 and June 2017, 125 ACS patients (mean age: 57.78 (±9.5) years, 78.4% males) were enrolled in this observational prospective study, 89 patients had been followed-up for six months. Patients were assessed based on history, clinical examination, 12-lead ECG, and coronary angiography. Results Subjects with a CHA2DS2-VASc score ≥2 had a higher proportion of multivessel disease (3.9%), left main coronary artery lesions (9.9%), and totally occluded, bifurcational, or long coronary lesions (60%) (All p-values<0.05). We found significant positive associations of the CHA2DS2-VASc score with the SYNTAX score (p<0.001) and the Gensini score (p<0.001). Receiver operating characteristic (ROC) curves were generated and cutoff value determined for the CHA2DS2-VASc score (cutoff>2; 76% sensitivity; 76.8% specificity; p<0.001) in predicting coronary multivessel diseases. Subjects with a CHA2DS2-VASc score ≥2 had a higher in-hospital complications, including heart failure, cardiogenic shock, renal impairment, and AF (all p-values<0.05). The CHA2DS2-VASc score showed significant positive associations with in-hospital (11.9%, p=0.21) and six-month mortality (25%, p=0.042). ROC curves were generated and cutoff value determined for the CHA2DS2-VASc score (cutoff>2; 88% sensitivity; 65.3% specificity; p<0.001) in predicting six-month-mortality. Multivariate logistic regression analysis showed that the CHA2DS2-VASc score (p<0.001 with odds ratio 2.28; 95% CI 1.47–3.53) and the GRACE score (p<0.001 with odds ratio 1.07; 95% CI 1.03–1.09) were predictors of six-month mortality. Conclusion CHA2DS2-VASc score is associated with increased CAD severity and in-hospital and six-month outcomes. Acknowledgement/Funding None