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Association of CHA2DS2-VASc score with thrombus burden in patients with acute myocardial infarction undergoing

Orhan Maden1, Özge Çakmak Karaaslan2, Yücel Kanal3

  • 1Department of Cardiology, Ankara City Hospital, Ankara, Turkey.

Herz
|October 5, 2021
PubMed

Insights

The CHA2DS2-VASc score effectively predicts high thrombus burden in patients with acute myocardial infarction undergoing saphenous vein graft percutaneous coronary intervention. This score offers a practical tool for risk stratification in these high-risk patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Saphenous vein graft (SVG) occlusion occurs in 15% of patients within one year post-bypass surgery.
  • The CHA2DS2-VASc score is established for predicting thromboembolic events in atrial fibrillation.
  • The predictive value of the CHA2DS2-VASc score for intracoronary thrombus burden in acute myocardial infarction (AMI) patients undergoing SVG percutaneous coronary intervention (PCI) requires evaluation.

Purpose of the Study:

  • To assess the predictive capability of the CHA2DS2-VASc score for intracoronary thrombus burden.
  • To determine if the CHA2DS2-VASc score can identify patients at high risk of thrombus burden during SVG-PCI for AMI.

Main Methods:

  • Retrospective analysis of 221 AMI patients who underwent SVG-PCI between 2012 and 2018.
  • Patients were categorized into low thrombus burden (LTB; TIMI 0-3) and high thrombus burden (HTB; TIMI 4-5) groups.
  • CHA2DS2-VASc scores were analyzed for association with HTB using univariate and multivariate regression, and ROC analysis.

Main Results:

  • Patients with HTB exhibited significantly higher CHA2DS2-VASc scores compared to LTB patients (p < 0.001).
  • Both continuous CHA2DS2-VASc score (OR: 1.573) and a score >3 (OR: 3.876) were significant predictors of HTB (p=0.004 and p=0.001, respectively).
  • Receiver-operating characteristic analysis identified an optimal CHA2DS2-VASc score cut-off of 3 for predicting HTB, with 67.9% sensitivity and 69.3% specificity.

Conclusions:

  • The CHA2DS2-VASc score serves as a practical and accessible tool for predicting high thrombus burden.
  • This score can aid in risk stratification for patients experiencing acute myocardial infarction who undergo saphenous vein graft percutaneous coronary intervention.
Abstract

Keywords:
CHA2DS2-VASc scoreCoronary artery bypass graftNo-reflowSaphenous vein graft diseaseThrombus burden

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