The superiority of CHADS2 and CHA2DS2-VASc scores in predicting the risk of stroke in patients with nonvalvular atrial fibrillation had been proved.
A retrospective study was conducted to?evaluate the predictive value of CHADS2 and CHA2DS2-VASc scores for?coronary artery lesions?and the prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI).
It was conducted by assessing the case report forms from January 2016 to August 2017, with a total of 524 patients diagnosed with STEMI. The correlation between CHADS2 and CHA2DS2-VASc scores with the patient’s demographic and clinical data, number of?coronary artery lesions, Gensini scores, the target vessel, time of hospitalisation and in-hospital adverse events (AEs) was analysed.
Mostly, single and double coronary lesions were found in STEMI patients. The scores were not meaningful for predicting the number of coronary lesions, but the CHADS2 score was significantly increased when the number increased for left main coronary artery lesion (P < 0.05), CHA2DS2-VASc score had shown no statistical difference (P > 0.05). The incidence of target lesions in STEMI patients was mainly left anterior descending coronary artery (LAD) and right coronary artery (RCA). There was a positive correlation between CHADS2 score with Gensini score (P < 0.05), but there was no exact correlation between CHA2DS2-VASc score and Gensini score (P > 0.05) for the severity of coronary lesions. For predicting target lesions (P > 0.05), the two scores were not meaningful.
The stratifications of two scores were significantly associated with hospitalisation time and adverse events during hospitalisation (P < 0.05). The group with a high score had longer hospitalisation time and more AEs during hospitalisation than the middle group and low score group statistically (P < 0.05).
The authors of the study conclude that CHADS2 scores predict the severity of coronary lesion and presence of left coronary artery in STEMI whereas, CHA2DS2-VASc score couldn’t do it. There was no significance in predicting the number of coronary lesions and the location of the target lesions in STEMI patients. Both scores also predicted the ability for patient hospitalisation and AEs during hospitalisation.