Predictive Accuracy of the CHA2DS2-VASc-HSF Score in Determining One-Year Cardiovascular Outcomes in Patients with Non-ST-Elevation Acute Coronary Syndrome: A Retrospective Study

Predictive Accuracy of the CHA2DS2-VASc-HSF Score in Determining One-Year Cardiovascular Outcomes in Patients with Non-ST-Elevation Acute Coronary Syndrome: A Retrospective Study

Introduction: To investigate the predictive accuracy of the CHA2DS2-VASc-HSF score in predicting the one-year mortality and major adverse cardiac and cerebrovascular events (MACCEs) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Patients and Methods: In this retrospective study, the study cohort was divided in to two groups based on the median CHA2DS2-VASc-HSF score: low-risk group (≤ 4 points) and high-risk group (> 4 points). Results: We enrolled 394 patients with NSTE-ACS (mean age: 58.7 ± 11.8 years). The CHA2DS2-VASc-HSF score independently predicted the coronary artery disease (CAD) severity (p< 0.01), one-year mortality (p< 0.01), and MACCEs (p< 0.01). The Global Registry for Acute Coronary Events (GRACE) risk score (GRS 1.0) independently predicted the CAD severity (p< 0.01), whereas the revised GRACE 2.0 risk score (GRS 2.0) independently predicted the one-year mortality (p< 0.01) and MACCEs (p< 0.01). The diagnostic performance of CHA2DS2-VASc-HSF was similar to GRS 2.0 in predicting the one-year mortality and MACCEs [area under the curve (AUC), 0.75 and 0.69 vs. 0.78 and 0.67; p= 0.41, p= 0.38, respectively) and better than GRS 1.0 for the CAD severity (AUC, 0.85 vs. 0.79; p= 0.03). The Kaplan-Meier curves displayed significantly higher one-year mortality and MACCEs in the high-risk group (p< 0.01) compared with the low-risk group (p< 0.01).Conclusion: The predictive accuracy of CHA2DS2-VASc-HSF is comparable to that of GRS 2.0 in determin-ing the long-term cardiovascular outcomes; thus, it could be considered as a predictive model for patients with NSTE-ACS.

___

  • 1. Amsterdam EA, Wenger NK, Brindis RG, Casey DE Jr, Ganiats TG, Holmes DR Jr, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol 2014;64:139-228.
  • 2. Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al.; ESC Scientific Document Group. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting with-out persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2016;37:267-315.
  • 3. Oner E, Gorgulu S, Aksu HU, Baycan OF, Erturk M, et al. GRACE and TIMI scores in predicting the extension of coronary artery disease in pa-tients with non-ST elevation myocardial infarction. Dicle Medical Jour-nal 2015;42:170-4.
  • 4. Roy SS, Abu Azam STM, Khalequzzaman M, Ullah M, Arifur Rah-man M. GRACE and TIMI risk scores in predicting the angiographic severity of non-ST elevation acute coronary syndrome. Indian Heart J 2018;70(Suppl 3):250-3.
  • 5. Fox KAA, Fitzgerald G, Puymirat E, Huang W, Carruthers K, Simon T, et al. Should patients with acute coronary disease be stratified for man-agement according to their risk? Derivation, external validation and out-comes using the updated GRACE risk score. BMJ Open 2014;4:e004425.
  • 6. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al.; ESC Scientific Document Group. 2016 ESC guidelines for the manage-ment of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016;37:2893-962.
  • 7. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al.; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the Ameri-can College of Cardiology/American Heart Association Task Force on practice guidelines and the heart rhythm society. J Am Coll Cardiol 2014;64:e1-76.
  • 8. Cetin M, Cakici M, Zencir C, Tasolar H, Baysal E, Balli M, et al. Predic-tion of coronary artery disease severity using CHA2DS2 and CHA2DS2-VASc scores and a newly defined CHA2DS2-VASc-HS Score. Am J Car-diol 2014;113:950-6.
  • 9. Kim KH, Kim W, Hwang SH, Kang WY, Cho SC, Kim W, et al.; Other Korean Working Group in Myocardial Infarction Registry Investigators. The CHA2DS2-VASc score can be used to stratify the prognosis of acute myocardial infarction patients irrespective of presence of atrial fibrilla-tion. J Cardiol 2015;65:121-7.
  • 10. Keskin K, Yildiz SS, Cetinkal G, Aksan G, Kilci H, et al. The value of CHA2DS2-VASc score in predicting all-cause mortality in patients with ST-segment elevation myocardial infarction who have undergone primary percutaneous coronary intervention. Acta Cardiol Sin 2017;33:598604.
  • 11. Satilmisoglu MH, Gul M, Yildiz G, Akgul O, Kaya M, Cakmak HA, et al. Prognostic value of CHA2DS2-VASc score in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention. Acta Cardiol 2016;71:663-9.
  • 12. Modi R, Patted SV, Halkati PC, Porwal S, Ambar S, Mr P, et al. CHA2DS2-VASc-HSF score-New predictor of severity of coronary artery disease in 2976 patients. Int J Cardiol 2017;228:1002-6.
  • 13. Uysal OK, Turkoglu C, Duran M, Kaya MG, Sahin DY, Gur M, et al. Pre-dictive value of newly defined CHA2DS2-VASc-HSF score for severity of coronary artery disease in ST segment elevation myocardial infarction. Kardiol Pol 2016;74:954-60.
  • 14. Al-shorbagy AN, Al-Cekelly MM, Dwedar AA, Soliman MH. The pre-dictive value of newly defined CHA2DS2-VASc-HSF score for severity of coronary artery disease in non ST segment elevation myocardial in-farction. Z U M J 2018;24:289-96.
  • 15. Garcia-Garcia HM, McFadden EP, Farb A, Mehran R, Stone GW, Spertus J, et al. Standardized end point definitions for coronary intervention tri-als: the Academic Research Consortium-2 consensus document. Circula-tion 2018;137:2635-50.
  • 16. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing areas under two or more correlated reciever operating characteristics curves: a non-paramentric approach. Biometrics 1988;44:837-45.
  • 17. Hudzik B, Szkodzinski J, Hawranek M, Lekston A, Polonski L, Gsior M. CHA2DS2-VASc score is useful in predicting poor 12-month outcomes following myocardial infarction in diabetic patients without atrial fibril-lation. Acta Diabetol 2016;53:807-15.
  • 18. Taşolar H, Çetin M, Ballı M, Bayramoğlu A, Otlu YÖ, Türkmen S, et al. CHA2DS2-VASc-HS score in non-ST elevation acute coronary syndrome patients: assessment of coronary artery disease severity and complexity and comparison to other scoring systems in the prediction of in-hospital major adverse cardiovascular events. Anatol J Cardiol 2016;16(10):742-8.
  • 19. Scheuner MT, Setodji CM, Pankow JS, Blumenthal RS, Keeler E. Gener-al cardiovascular risk profile identifies advanced coronary artery calcium and is improved by family history. The Multiethnic Study of Atheroscle-rosis. Circ Cardiovasc Genet 2010;3:97-105.
  • 20. Ridker PM, Paynter NP, Rifai N, Gaziano JM, Cook NR. C-reactive pro-tein and parental history improve global cardiovascular risk prediction: the Reynolds Risk Score for men. Circulation 2008;118:2243-51.
  • 21. Yanez ND, Burke GL, Manolio T, Gardin JM, Polak J; for the CHS Col-laborative Research Group. Sibling history of myocardial infarction or stroke and risk of cardiovascular disease in the elderly: The Cardiovascu-lar Health Study. Ann Epidemiol 2009;19:858-66.
  • 22. Narins CR, Zareba W, Moss AJ, Marder VJ, Ridker PM, Krone RJ, et al. Relationship between intermittent claudication, inflammation, thrombo-sis, and recurrent cardiac events among survivors of myocardial infarc-tion. Arch Intern Med 2004;164:440-6.
  • 23. Banks E, Joshy G, Korda RJ, Stavreski B, Soga K, Egger S, et al. To-bacco smoking and risk of 36 cardiovascular disease subtypes: fatal and non-fatal outcomes in a large prospective Australian study. BMC Med 2019;17:128.
  • 24. Valerio L, Peters RJ, Zwinderman AH, Pinto-Sietsma SJ. Association of family history with cardiovascular disease in hypertensive individuals in a multiethnic population. J Am Heart Assoc 2016;5:e004260.
  • 25. Malmberg K, Yusuf S, Gerstein HC, Brown J, Zhao F, Hunt D, et al. Im-pact of diabetes on long-term prognosis in patients with unstable angına and non-Q-wave myocardial infarction: results of the OASIS (Organiza-tion to Assess Strategies for Ischemic Syndromes) Registry. Circulation 2000;102:1014-9.
  • 26. Bahit MC, Lopes RD, Clare RM, Newby LK, Pieper KS, Van de Werf F, et al. Heart failure complicating non-ST-segment elevation acute coro-nary syndrome: timing, predictors, and clinical outcomes. JACC Heart Fail 2013;1:223-9.
  • 27. Bundhun PK, Wu ZJ, Chen MH. Impact of modifiable cardiovascular risk factors on mortality after percutaneous coronary intervention: a sys-tematic review and meta-analysis of 100 studies. Medicine (Baltimore) 2015;94:e2313.
  • 28. Tamosiunas A, Radisauskas R, Klumbiene J, Bernotiene G, Petkeviciene J, Luksiene D, et al. The prognostic value of family history for the esti-mation of cardiovascular mortality risk in men: results from a long-term cohort study in Lithuania. PLoS One 2015;10:e0143839.
  • 29. Banks E, Joshy G, Korda RJ, Stavreski B, Soga K, Egger S, et al. To-bacco smoking and risk of 36 cardiovascular disease subtypes: fatal and non-fatal outcomes in a large prospective Australian study. BMC Med 2019;17:128.
  • 30. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX score: an angiographic tool grading the complex-ity of coronary artery disease. EuroIntervention 2005;1:219-27.
  • 31. El Kersh AM, Reda AA, El Hadad MG, El Sharnouby KH. Correlation between SYNTAX score and pattern of risk factors in patients referred for coronary angiography in cardiology department, Menoufia Univer-sity. World J Cardiovasc Dis 2018;8:431-9.
  • 32. Montero-Cabezas JM, Karalis I, Wolterbeek R, Kraaijeveld AO, Hoefer IE, Pasterkamp G, et al. Classical determinants of coronary artery disease as predictors of complexity of coronary lesions, assessed with the SYN-TAX score. Neth Heart J 2017;25:490-7.
  • 33. Otaki Y, Gransar H, Berman DS, Cheng VY, Dey D, Lin FY, et al. Impact of family history of coronary artery disease in young individuals (from the CONFIRM registry). Am J Cardiol 2013;111:1081-6.
  • 34. Sobiczewski W, Wirtwein M, Trybala E, Gruchala M. Severity of coro-nary atherosclerosis and stroke incidence in 7-year follow-up. J Neurol 2013;260:1855-8.
  • 35. Vuruskan E, Saracoglu E, Polat M, Duzen IV. Prediction of coronary artery disease severity in lower extremity artery disease patients: a cor-relation study of TASC II classification, Syntax and Syntax II scores. Cardiol J 2017;24:495-501.
Koşuyolu Heart Journal-Cover
  • ISSN: 2149-2972
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 1990
  • Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi
Sayıdaki Diğer Makaleler

Dinamik Sol Ventrikül Çıkış Yolu Obstrüksiyonu: Takotsubo Kardiyomiyopatisinin Potansiyel Komplikasyonu

Özgür AKBAL, Berhan KESKİN, Ahmet KARADUMAN, Seda TANYERİ, Ali KARAGÖZ

Komplike Akut Tip B Aortik Diseksiyonların Tedavisinde Donmuş Fil Hortumu Prosedürü

Mustafa AKBULUT, Adnan AK, Serpil TAŞ, Özgür ARSLAN, Arzu ANTAL DÖNMEZ, Davut ÇEKMECELİOĞLU, Mesut ŞİŞMANOĞLU, Mehmet Altuğ TUNCER

ST-Yükselmesiz Akut Koroner Sendromlu Hastalarda Bir Yıllık Kardiyovasküler Sonuçların Belirlenmesinde CHA2 DS2 -VASc-HSF Skorunun Prediktif Değeri: Retrospektif Bir Çalışma

Muhsin KALYONCUOĞLU, Gündüz DURMUŞ, Erdal BELEN, Mehmet Mustafa CAN

Mekanik Aort Kapak Replasmanı Yapılan Hastalarda Hasta Kapak Uyumsuzluğunun Fonksiyonel Mitral Yetmezliğine Etkileri

Mehmet Emir EROL, Sertan ÖZYALÇIN, Sinan Sabit KOCABEYOĞLU

Eriyebilen Stentlerin Prosedür Üzerine Olan Etkilerinin İlaç Kaplı Stentlerle Karşılaştırılması

Beytullah ÇAKAL

Koroner Arter Ektazi Olan Hipertansif Hastalarda Nötrofil-Lenfosit Oranının ve Ortalama Trombosit Hacminin Değerlendirilmesi

Mehmet İNANIR, Gökhan ALICI, Emrah ACAR, Hayati EREN, Müjgan GÜRLER, Sait ALAN

Predictive Accuracy of the CHA2DS2-VASc-HSF Score in Determining One-Year Cardiovascular Outcomes in Patients with Non-ST-Elevation Acute Coronary Syndrome: A Retrospective Study

Muhsin KALYONCUOĞLU, Gündüz DURMUŞ, Erdal BELEN, Mehmet Mustafa CAN

İnfantil Dönem Sonrası Cerrahi Tamir Yapılan Ventriküler Septal Defektli Hastaların Erken ve Orta Dönem Sonuçları

Servet ERGÜN, Mustafa GÜNEŞ, Zeynep Gülben KÜK ÖZALP, Erkut ÖZTÜRK, İ̇smihan Selen ONAN, Alper GÜZELTAŞ, Sertaç HAYDİN

Hipertansif Hastalarda Torasik Aortik İntima Media Kalınlığı Renal Doppler Parametreleri ile İlişkilidir

Yurdaer DÖNMEZ, Armağan ACELE, Atilla BULUT, Mehmet KAPLAN, Hasan KOCA, Ayşe SELCAN KOÇ, Burçak ÇAKIR PEKÖZ, Mevlüt KOÇ

Adrenalin Stres Testi Sırasında Ortaya Çıkan Katekolaminerjik Polimorfik Ventriküler Taşikardinin Farklı Yüzleri

Hasan KAFALI, Erkut ÖZTÜRK, Yakup ERGÜL