CHA2DS2-VASc Score as Apredictor for Severity of Coronary Artery Disease and Thrombus Burden in Patients with Acute ST segment Elevation Myocardial Infarction (STEMI) Undergoing Primary Percutaneous Intervention
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Abstract
Background:CHA2DS2-VASc score has a close association with adverse outcomes and cardiovascular prognosis in a broad range of patient populations such as heart failure, stable CAD, and ACS, regardless of having AF, but the predictive value of this score on coronary atherosclerotic burden in ACS still remains unclear.
Objective:To improve the quality of health service by introducing a simple score for physicians for easy risk stratification for patients presented with acute STEMI.
Methods: One hundred patients were enrolled; All patients were subjected to history, examination, ECG, echocardiography, CHA2DS2-VASc score calculation and coronary angiography to assessseverity of coronary artery disease by SYNTAX score and thrombus burden assessment by the thrombolysis in myocardial infarction (TIMI) grade.
Results:Thediagnostic accuracy ofCHA2DS2-VASc Score in prediction of no of multi-vessel disease, the best cutoff point was score >4 with 73.7% sensitivity and 60% specificity. While its diagnostic accuracy in prediction of severity of CAD based on high SS, the best cutoff point was score >4 with 87% sensitivity and 57.1% specificity. Finally, its diagnostic accuracy in prediction of severity of high thrombus grade, the best cutoff point was score >4 with 72% sensitivity and 66% specificity.CHA2DS2-VASc > 4 is an independent predictor of high thrombus burden and had significant positive correlation with high thrombus burden, p 0.011 and OR 3.9.
Conclusion:CHA2DS2-VASc score is a good and reliable predictor of intracoronary thrombus burden and severity of CAD in ST segment elevation myocardial infarction patients undergoing primary PCI.