Bozbay Mehmet, Uyarel Huseyin, Cicek Gokhan, Oz Ahmet, Keskin Muhammed, Murat Ahmet, Yildirim Ersin, Karaca Gurkan, Ergelen Mehmet, Eren Mehmet
1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Istanbul, Turkey.
2 Department of Cardiology, School of Medicine, Bezmi Alem Vakif University, Istanbul, Turkey.
Clin Appl Thromb Hemost. 2017 Mar;23(2):132-138. doi: 10.1177/1076029616646874. Epub 2016 Jul 9.
CHADS-VASc score includes similar risk factors for coronary artery disease. We hypothesized that admission CHADS-VASc score might be predictive of adverse clinical outcomes for patients with ST-segment elevation myocardial infarction (STEMI) who were undergoing primary percutaneous coronary intervention. A total of 647 patients with STEMI enrolled in this study. The study population was divided into 2 groups according to their admission CHADS-VASc score. The low group (n = 521) was defined as CHADS-VASc score ≤2, and the high group (n = 126) was defined as CHADS-VASc score >2. Patients in the high group had significantly higher incidence of in-hospital cardiovascular mortality (8.7% vs 1.9%; P < .001). Long-term mortality was significantly frequent in the high group (13.4% vs 3.6%, P < .001). Hypertension, admission CHADS-VASc score, and Killip class >1 were independent predictors of long-term mortality. Admission CHA2DS2-VASc score >2 was identified as an effective cutoff point for long-term mortality (area under curve = 0.821; 95% confidence interval: 0.76-0.89; P < .001). CHADS-VASc score is a simple, very useful, easily remembered bedside score for predicting in-hospital and long-term adverse clinical outcomes in STEMI.
CHADS-VASc评分包含与冠状动脉疾病相似的危险因素。我们推测,入院时的CHADS-VASc评分可能对接受直接经皮冠状动脉介入治疗的ST段抬高型心肌梗死(STEMI)患者的不良临床结局具有预测作用。本研究共纳入647例STEMI患者。根据入院时的CHADS-VASc评分将研究人群分为两组。低分组(n = 521)定义为CHADS-VASc评分≤2,高分组(n = 126)定义为CHADS-VASc评分>2。高分组患者的院内心血管死亡率显著更高(8.7% 对1.9%;P < .001)。高分组的长期死亡率明显更高(13.4% 对3.6%,P < .001)。高血压、入院时的CHADS-VASc评分以及Killip分级>1是长期死亡率的独立预测因素。入院时的CHA2DS2-VASc评分>2被确定为长期死亡率的有效截断点(曲线下面积 = 0.821;95% 置信区间:0.76 - 0.89;P < .001)。CHADS-VASc评分是一种简单、非常有用且易于记忆的床旁评分,可用于预测STEMI患者的院内及长期不良临床结局。