CHA2DS2-VASc Score as an Independent Predictor of Suboptimal Reperfusion and Short-Term Mortality after Primary PCI in Patients with Acute ST Segment Elevation Myocardial Infarction
<i>Background and objectives</i>: We aimed to demonstrate the clinical utility of CHA2DS2-VASc score in risk assessment of patients with STEMI regarding adverse clinical outcomes particularly no-reflow phenomenon. <i>Materials and Methods</i>: We designed a retrospective coho...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2019-02-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1010-660X/55/2/35 |
| _version_ | 1797728204982583296 |
|---|---|
| author | Ammar Ashoori Hamidreza Pourhosseini Saeed Ghodsi Mojtaba Salarifar Ebrahim Nematipour Mohammad Alidoosti Ali-Mohammad Haji-Zeinali Yones Nozari Alireza Amirzadegan Hassan Aghajani Arash Jalali Zahra Hosseini Yaser Jenab Babak Geraiely Negar Omidi |
| author_facet | Ammar Ashoori Hamidreza Pourhosseini Saeed Ghodsi Mojtaba Salarifar Ebrahim Nematipour Mohammad Alidoosti Ali-Mohammad Haji-Zeinali Yones Nozari Alireza Amirzadegan Hassan Aghajani Arash Jalali Zahra Hosseini Yaser Jenab Babak Geraiely Negar Omidi |
| author_sort | Ammar Ashoori |
| collection | DOAJ |
| description | <i>Background and objectives</i>: We aimed to demonstrate the clinical utility of CHA2DS2-VASc score in risk assessment of patients with STEMI regarding adverse clinical outcomes particularly no-reflow phenomenon. <i>Materials and Methods</i>: We designed a retrospective cohort study using the data of Tehran Heart Center registry for acute coronary syndrome. The study included 1331 consecutive patients with STEMI who underwent primary angioplasty. Patients were divided into two groups according to low and high CHA2DS2-VASc score. Angiographic results of reperfusion were inspected to evaluate the association of high CHA2DS2-VASc score and the likelihood of suboptimal TIMI flow. The secondary endpoint of the study was short-term in-hospital mortality of all cause. <i>Results</i>: The present study confirmed that CHA2DS2-VASc model enables us to determine the risk of no-reflow and all-cause in-hospital mortality independently. Odds ratios were 1.59 (1.30–2.25) and 1.60 (1.17–2.19), respectively. Moreover, BMI, high thrombus grade, and cardiogenic shock were predictors of failed reperfusion (odds were 1.07 (1.01–1.35), 1.59 (1.28–1.76), and 8.65 (3.76–24.46), respectively). We showed that using a cut off value of ≥ two in CHA2DS2-VASc model provides a sensitivity of 69.7% and specificity of 64.4% for discrimination of increased mortality hazards. Area under the curve: 0.72 with 95% CI (0.62–0.81). <i>Conclusions</i>: Calculation of CHA2DS2-VASc score applied as a simple risk stratification tool before primary PCI affords great predictive power. Furthermore, incremental values are obtained by using both CHA2DS2-VASc and no-reflow regarding mortality risk assessment. |
| first_indexed | 2024-03-12T11:10:40Z |
| format | Article |
| id | doaj.art-6c13986ef2ea4be3a0d8a2511ab2d574 |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T11:10:40Z |
| publishDate | 2019-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-6c13986ef2ea4be3a0d8a2511ab2d5742023-09-02T02:55:21ZengMDPI AGMedicina1010-660X2019-02-015523510.3390/medicina55020035medicina55020035CHA2DS2-VASc Score as an Independent Predictor of Suboptimal Reperfusion and Short-Term Mortality after Primary PCI in Patients with Acute ST Segment Elevation Myocardial InfarctionAmmar Ashoori0Hamidreza Pourhosseini1Saeed Ghodsi2Mojtaba Salarifar3Ebrahim Nematipour4Mohammad Alidoosti5Ali-Mohammad Haji-Zeinali6Yones Nozari7Alireza Amirzadegan8Hassan Aghajani9Arash Jalali10Zahra Hosseini11Yaser Jenab12Babak Geraiely13Negar Omidi14Tehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranDepartment of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, IranTehran Heart Center, Tehran University of Medical Sciences, Tehran 1411713138, Iran<i>Background and objectives</i>: We aimed to demonstrate the clinical utility of CHA2DS2-VASc score in risk assessment of patients with STEMI regarding adverse clinical outcomes particularly no-reflow phenomenon. <i>Materials and Methods</i>: We designed a retrospective cohort study using the data of Tehran Heart Center registry for acute coronary syndrome. The study included 1331 consecutive patients with STEMI who underwent primary angioplasty. Patients were divided into two groups according to low and high CHA2DS2-VASc score. Angiographic results of reperfusion were inspected to evaluate the association of high CHA2DS2-VASc score and the likelihood of suboptimal TIMI flow. The secondary endpoint of the study was short-term in-hospital mortality of all cause. <i>Results</i>: The present study confirmed that CHA2DS2-VASc model enables us to determine the risk of no-reflow and all-cause in-hospital mortality independently. Odds ratios were 1.59 (1.30–2.25) and 1.60 (1.17–2.19), respectively. Moreover, BMI, high thrombus grade, and cardiogenic shock were predictors of failed reperfusion (odds were 1.07 (1.01–1.35), 1.59 (1.28–1.76), and 8.65 (3.76–24.46), respectively). We showed that using a cut off value of ≥ two in CHA2DS2-VASc model provides a sensitivity of 69.7% and specificity of 64.4% for discrimination of increased mortality hazards. Area under the curve: 0.72 with 95% CI (0.62–0.81). <i>Conclusions</i>: Calculation of CHA2DS2-VASc score applied as a simple risk stratification tool before primary PCI affords great predictive power. Furthermore, incremental values are obtained by using both CHA2DS2-VASc and no-reflow regarding mortality risk assessment.https://www.mdpi.com/1010-660X/55/2/35no-reflowSTEMICHA2DS2-VASc scorereperfusionmortality |
| spellingShingle | Ammar Ashoori Hamidreza Pourhosseini Saeed Ghodsi Mojtaba Salarifar Ebrahim Nematipour Mohammad Alidoosti Ali-Mohammad Haji-Zeinali Yones Nozari Alireza Amirzadegan Hassan Aghajani Arash Jalali Zahra Hosseini Yaser Jenab Babak Geraiely Negar Omidi CHA2DS2-VASc Score as an Independent Predictor of Suboptimal Reperfusion and Short-Term Mortality after Primary PCI in Patients with Acute ST Segment Elevation Myocardial Infarction Medicina no-reflow STEMI CHA2DS2-VASc score reperfusion mortality |
| title | CHA2DS2-VASc Score as an Independent Predictor of Suboptimal Reperfusion and Short-Term Mortality after Primary PCI in Patients with Acute ST Segment Elevation Myocardial Infarction |
| title_full | CHA2DS2-VASc Score as an Independent Predictor of Suboptimal Reperfusion and Short-Term Mortality after Primary PCI in Patients with Acute ST Segment Elevation Myocardial Infarction |
| title_fullStr | CHA2DS2-VASc Score as an Independent Predictor of Suboptimal Reperfusion and Short-Term Mortality after Primary PCI in Patients with Acute ST Segment Elevation Myocardial Infarction |
| title_full_unstemmed | CHA2DS2-VASc Score as an Independent Predictor of Suboptimal Reperfusion and Short-Term Mortality after Primary PCI in Patients with Acute ST Segment Elevation Myocardial Infarction |
| title_short | CHA2DS2-VASc Score as an Independent Predictor of Suboptimal Reperfusion and Short-Term Mortality after Primary PCI in Patients with Acute ST Segment Elevation Myocardial Infarction |
| title_sort | cha2ds2 vasc score as an independent predictor of suboptimal reperfusion and short term mortality after primary pci in patients with acute st segment elevation myocardial infarction |
| topic | no-reflow STEMI CHA2DS2-VASc score reperfusion mortality |
| url | https://www.mdpi.com/1010-660X/55/2/35 |
| work_keys_str_mv | AT ammarashoori cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT hamidrezapourhosseini cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT saeedghodsi cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT mojtabasalarifar cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT ebrahimnematipour cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT mohammadalidoosti cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT alimohammadhajizeinali cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT yonesnozari cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT alirezaamirzadegan cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT hassanaghajani cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT arashjalali cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT zahrahosseini cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT yaserjenab cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT babakgeraiely cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction AT negaromidi cha2ds2vascscoreasanindependentpredictorofsuboptimalreperfusionandshorttermmortalityafterprimarypciinpatientswithacutestsegmentelevationmyocardialinfarction |