Predictive Value of CHA₂DS₂-VASc Score for Ischemic Events in Patients Undergoing Percutaneous Coronary Intervention

Area of Science:

• Cardiology
• Interventional Cardiology
• Clinical Risk Stratification

Background:

• Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
• Predicting long-term ischemic events after PCI is crucial for patient management.
• The CHA2DS2-VASc score is established for stroke risk in atrial fibrillation but its utility in PCI patients is less understood.

Purpose of the Study:

• To evaluate the association between preprocedure CHA2DS2-VASc score and 1-year ischemic events in patients undergoing PCI.
• To assess the CHA2DS2-VASc score's accuracy in predicting long-term adverse outcomes after PCI.

Main Methods:

• A cohort of 2533 patients undergoing PCI between July 2009 and August 2011 was analyzed.
• Univariate and multivariable logistic regression models were used to assess the association between CHA2DS2-VASc score and ischemic events.
• Receiver operating characteristic (ROC) curves evaluated the predictive accuracy of the CHA2DS2-VASc score.

Main Results:

• Patients with a CHA2DS2-VASc score ≥2 had significantly higher rates of long-term death (9.5% vs 2.8%), cardiac death (2.9% vs 1.4%), and nonfatal stroke (1.9% vs 0.7%) compared to those with a score ≤1.
• The CHA2DS2-VASc score was a significant predictor of all-cause death (OR: 3.71 [95% CI: 1.89-7.30]).
• Risk factors for death differed based on CHA2DS2-VASc score, with older age being a common factor, alongside other comorbidities in higher-risk groups.

Conclusions:

• The preprocedure CHA2DS2-VASc score is associated with long-term ischemic events, including all-cause death, cardiac death, and stroke, in patients undergoing PCI.
• The CHA2DS2-VASc score demonstrates potential utility for risk stratification in patients undergoing PCI.
• Further research may refine the application of CHA2DS2-VASc score for optimizing PCI patient care.