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The Role of CHA₂DS₂-VASc Score in Predicting Clinical Complications Following Primary Percutaneous Coronary

Dwi Ariyanti1,2, Muhammad Farhan Hibatulloh3, Cinday Kinanti Pramusinta3

  • 1Subspecialist Study Program of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|October 6, 2025
PubMed

Insights

The CHA₂DS₂-VASc score effectively predicts adverse cardiovascular outcomes like ISR, AST, and MACE after PCI. This simple score aids bedside risk assessment for patients undergoing percutaneous coronary intervention.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Risk Stratification

Background:

  • The CHA₂DS₂-VASc score is established for stroke risk in atrial fibrillation (AF).
  • Its utility in predicting outcomes post-percutaneous coronary intervention (PCI) is under investigation.
  • Current evidence on CHA₂DS₂-VASc score's role in PCI patients is limited.

Purpose of the Study:

  • To systematically evaluate the predictive capability of the CHA₂DS₂-VASc score for adverse cardiovascular events following PCI.
  • To synthesize existing data on the association between CHA₂DS₂-VASc score and post-PCI complications.
  • To assess the potential of CHA₂DS₂-VASc score as a risk stratification tool in the context of PCI.

Main Methods:

  • A systematic review and meta-analysis adhering to PRISMA 2020 guidelines.
  • Inclusion of ten observational studies comprising 14,143 patients undergoing PCI.
  • Analysis of primary outcomes including In-Stent Restenosis (ISR), Angiographic Stenosis (AST), and Major Adverse Cardiovascular Events (MACE) using random-effects models.

Main Results:

  • Higher CHA₂DS₂-VASc scores were significantly linked to increased risks of ISR (OR: 2.21; 95% CI: 1.75-2.78).
  • A significant association was found between elevated CHA₂DS₂-VASc scores and higher rates of AST (OR: 1.99; 95% CI: 1.53-2.60).
  • The CHA₂DS₂-VASc score demonstrated a significant association with MACE (HR: 1.44; 95% CI: 1.22-1.69) in patients post-PCI.

Conclusions:

  • The CHA₂DS₂-VASc score exhibits robust predictive value for ISR, AST, and MACE after PCI.
  • Its simplicity and accessibility make it a practical tool for immediate clinical risk assessment.
  • Further prospective, multicenter studies are warranted to validate the CHA₂DS₂-VASc score in non-AF populations undergoing PCI.
Abstract

Keywords:
CHA₂DS₂‐VASc scoreMACEin‐stent restenosispercutaneous coronary interventionstent thrombosis

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