Predictive value of CHADS2 and CHA2DS2-VASc scores for coronary artery lesions and in-hospital prognosis of patients with acute ST-segment elevation myocardial infarction

• Published in: BMC cardiovascular disorders 2021-09, Vol.21 (1), p.1-439, Article 439
• Main Authors: Li, Xiaoli, Zeng, Zhen, Yang, Xinchun, Wang, Hongjiang
• Format: Article
• Language: English
• Subjects: Acute ST-segment elevation myocardial infarction; Adverse events; Adverse events during hospitalization; Age; Blood pressure; Cardiac arrhythmia; Cardiovascular disease; CHA2DS2-VASc score; CHADS2 score; Coronary arteries; Coronary artery; Coronary vessels; Correlation analysis; Diabetes; Gender; Gensini score; Health aspects; Heart attack; Heart attacks; Heart rate; Hypertension; Lesions; Medical imaging; Mortality; Myocardial infarction; Patients; Prognosis; Thrombosis; Transient ischemic attack
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-021-02257-2

Objective To evaluate the predictive value of CHADS.sub.2 and CHA.sub.2DS.sub.2-VASc scores for coronary artery lesions and in-hospital prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 524 patients who were diagnosed with STEMI from January 2016 to August 2017 were retrospectively reviewed. The correlation between CHADS.sub.2 and CHA.sub.2DS.sub.2-VASc scores with the patients' clinical data, number of coronary lesions, Gensini scores, the target vessel and hospitalization time and in-hospital adverse events (AEs) was analyzed. Results The number of coronary lesions in STEMI patients was mainly single and double lesions. The CHADS.sub.2 and CHA.sub.2DS.sub.2-VASc scores were not meaningful for predicting the number of coronary lesions. However, for left main coronary artery lesion, CHADS.sub.2 score was significantly increased when the number increased (P < 0.05), but CHA.sub.2DS.sub.2-VASc score showed no statistical difference (P > 0.05). The incidence of target lesions in STMEI patients was mainly left anterior descending coronary artery (LAD) and right coronary artery (RCA). The two scores were not meaningful for predicting target lesions (P > 0.05). For the severity of coronary lesions, there was positive correlation between CHADS.sub.2 score with Gensini score (P < 0.05), but no exact correlation between CHA.sub.2DS.sub.2-VASc score and Gensini score (P > 0.05). The stratifications of CHADS.sub.2 score and CHA.sub.2DS.sub.2-VASc score were significantly associated with hospitalization time and adverse events during hospitalization (P < 0.05). The high score group had longer hospitalization time and more AEs during hospitalization than the low score group and the middle group statistically (P < 0.05). Conclusion CHADS.sub.2 score had a certain value to predict the severity of coronary lesion and the presence of left main coronary artery in STEMI. The CHA.sub.2DS.sub.2-VASc score had no predictive ability to do it. There was no significant value in predicting the number of coronary lesions and the location of the target lesions in STEMI patients. However, both scores had the predictive ability for patient hospitalization and AEs during hospitalization. Keywords: Acute ST-segment elevation myocardial infarction, CHADS.sub.2 score, CHA.sub.2DS.sub.2-VASc score, Gensini score, Adverse events during hospitalization