Predictive accuracy of CHA2DS2-VASc score in determining infarct-related artery patency in patients with ST-elevation myocardial infarction
Kartal Koşuyolu Yüksek İhtisas Eğitim Ve Araştırma Hastanesi, Kardiyoloji, Istanbul, Turkey
Keywords: cha2ds2-vasc score,st-elevation myocardial infarction,i̇nfarct-releated artery patency
Objectives: The objective of this study was to evaluate the predictive accuracy of CHA2DS2-VASc score in determining IRA patency in STEMI patients.
Patients and Methods: A total of 723 patients who presented to our hospital with chest pain and underwent PPCI with the diagnosis of STEMI were retrospectively analyzed. CHA2DS2-VASc score was calculated separately for all patients. Study population was divided into two groups as the occluded IRA group (TIMI 0,1,2) and patent IRA group (TIMI 3). A multivariate logistic regression analysis was performed in order to determine predictive value of CHA2DS2-VASc score.
Results: There were TIMI 0, 1 or 2 flow (occluded IRA group) in 568 (78.6%) patients and TIMI 3 flow (patent IRA group) in 155 (21.4%) patients. Patients in the occluded IRA group had a significantly higher CHA2DS2-VASc score compared to the patent IRA group (2 ± 1 vs. 1 ± 1, p <0.001). The result of receiver operating characteristic (ROC) curve analysis carried out to predict IRA patency was 0.74. We found that a CHA2DS2-VASc score <2 predicted IRA patency with a sensitivity of 70.9% and a specificity of 44.5% (AUC:0.735, 95% CI:0.691-0.779, p<0.001).
Conclusion: The CHA2DS2-VASc score can be used as a simple and reliable tool to predict IRA patency in STEMI patients undergoing PPCI.