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CHA2DS2-VASc score for in-hospital recurrence risk stratification in patients with myocardial infarction

Hui Pang1, Xu Zhu1, Iokfai Cheang1

  • 1Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

Frontiers in Cardiovascular Medicine
|December 19, 2022
PubMed

Insights

The modified CHA2DS2-VASc score better predicts recurrent myocardial infarction (MI) than the standard CHA2DS2-VASc score, especially in men. This finding aids in secondary prevention strategies after MI.

Area of Science:

  • Cardiology
  • Clinical Risk Stratification
  • Cardiovascular Research

Background:

  • The CHA2DS2-VASc score is established for predicting stroke risk in atrial fibrillation.
  • Its predictive value for recurrent myocardial infarction (MI) remains less understood.

Purpose of the Study:

  • To evaluate the predictive performance of the CHA2DS2-VASc and modified CHA2DS2-VASc (MCHA2DS2-VASc) scores for recurrent MI.
  • To compare the efficacy of these scores in identifying high-risk patients post-MI.

Main Methods:

  • Retrospective observational cohort study of adult inpatients with MI.
  • Calculation of CHA2DS2-VASc and MCHA2DS2-VASc scores for all patients.
  • Logistic regression analysis to assess the association of scores with recurrent MI.

Main Results:

  • The study included 6,700 MI patients; 11.3% experienced recurrence.
  • Both CHA2DS2-VASc and MCHA2DS2-VASc scores were independently associated with recurrence.
  • MCHA2DS2-VASc demonstrated superior predictive value (AUC 0.757 vs. 0.676) over CHA2DS2-VASc for overall recurrence risk, particularly in men.

Conclusions:

  • The CHA2DS2-VASc and MCHA2DS2-VASc scores are validated for predicting recurrence post-MI.
  • MCHA2DS2-VASc offers enhanced utility for secondary prevention after MI, especially in male patients.
  • MCHA2DS2-VASc is more discriminatory for identifying high-risk patients, with specific nuances in women.
Abstract

Keywords:
CHA2DS2-VAScmyocardial infarctionrecurrencerisk stratificationsex differences

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