Department of Cardiology, Ankara City Hospital, Ankara, Turkey.
Department of Cardiology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
Herz. 2022 Oct;47(5):456-464. doi: 10.1007/s00059-021-05070-x. Epub 2021 Oct 4.
The rate of saphenous vein graft (SVG) occlusion within the first year of bypass graft surgery is 15%. The CHADS-VASc score is used to predict the risk of thromboembolic events in patients with nonvalvular atrial fibrillation. We aimed to evaluate the predictive role of the CHADS-VASc score in the estimation of intracoronary thrombus burden in patients with acute myocardial infarction (AMI) who underwent SVG-PCI.
We retrospectively evaluated 221 patients who were admitted with AMI and underwent PCI of SVGs at the Department of Cardiology in the Turkiye Yuksek Ihtisas Education and Research Hospital between 2012 and 2018. The study population was divided into two groups according to their Thrombolysis in Myocardial Infarction (TIMI) thrombus grade: low thrombus burden (LTB; TIMI 0-3) and high thrombus burden (HTB; TIMI 4 and 5).
The study included 221 patients with a mean age of 63.3 ± 6.7 years. The patients with HTB had significantly higher CHADS-VASc scores (p < 0.001) compared with LTB patients. Univariate and multivariate regression analysis demonstrated that both CHADS-VASc score (OR: 1.573, 95% CI: 1.153-2.147, p = 0.004) as a continuous variable and a binary cut-off level of the CHADS-VASc score > 3 (OR: 3.876, 95% CI: 1.705-8.808, p = 0.001) were significantly associated with HTB. The ability of the CHADS-VASc score to predict HTB burden was evaluated by receiver-operating characteristics analysis curve analysis. The optimum cut-off value of the CHADS-VASc score for predicting HTB was 3 (with a sensitivity of 67.9% and a specificity of 69.3%) according to the Youden index.
The CHADS-VASc score can be used as an easy practical tool to predict HTB in AMI patients undergoing SVG-PCI.
旁路移植术后第一年，隐静脉移植物（SVG）闭塞率为 15%。CHADS-VASc 评分用于预测非瓣膜性心房颤动患者血栓栓塞事件的风险。我们旨在评估 CHADS-VASc 评分在预测接受 SVG-PCI 的急性心肌梗死（AMI）患者冠状动脉内血栓负荷中的预测作用。
我们回顾性评估了 2012 年至 2018 年期间在土耳其高等专科教育和研究医院心脏病科因 AMI 接受 SVG-PCI 的 221 例患者。根据他们的血栓溶解在心肌梗死（TIMI）血栓分级，将研究人群分为两组：低血栓负荷（LTB；TIMI 0-3）和高血栓负荷（HTB；TIMI 4 和 5）。
研究纳入了 221 例平均年龄为 63.3±6.7 岁的患者。与 LTB 患者相比，HTB 患者的 CHADS-VASc 评分明显更高（p<0.001）。单因素和多因素回归分析表明，CHADS-VASc 评分（OR：1.573，95%CI：1.153-2.147，p=0.004）作为连续变量和 CHADS-VASc 评分的二分类截断值>3（OR：3.876，95%CI：1.705-8.808，p=0.001）均与 HTB 显著相关。通过受试者工作特征分析曲线分析评估 CHADS-VASc 评分预测 HTB 负荷的能力。根据 Youden 指数，CHADS-VASc 评分预测 HTB 的最佳截断值为 3（灵敏度为 67.9%，特异性为 69.3%）。
CHADS-VASc 评分可作为一种简单实用的工具，用于预测接受 SVG-PCI 的 AMI 患者的 HTB。
