University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul - Turquia.
Arq Bras Cardiol. 2022 Sep;119(3):393-399. doi: 10.36660/abc.20210670.
The CHA2DS2-VASc score is associated with adverse clinical outcomes in patients with cardiovascular disease. The residual Syntax score (rSS) is a scoring tool which has prognostic value in patients with ST segment elevation myocardial infarction (STEMI).
Our aim in this study is to investigate the predictive value of the CHA2DS2-VASc score on rSS in STEMI patients.
A total of 688 consecutive patients with STEMI undergoing percutaneous coronary intervention were evaluated. Baseline demographic and clinical variables besides the CHA2DS2-VASc score were assessed. The patients were divided into two groups; patients with rSS of 8 or below as group 1 (509 patients) and more than 8 as group 2 (179 patients). A p-value < 0.05 was considered statistically significant.
The CHA2DS2-VASc score was higher in group 2 [1 (0-2); 1 (1-3), p<0.001] compared to group 1. The incidence of hypertension [151 (29.7%); 73 (40.8%), p=0.006], patients ≥75 years [18 (3.5%); 21 (11.7%), p<0.001], diabetes mellitus [85 (16.7%); 50 (27.9%), p=0.001] and vascular disease [12 (2.4%); 11 (6.1%), p=0.029] were higher in group 2. In multivariate logistic regression analysis, the CHA2DS2-VASc score (OR=1.355; 95%CI=1.171-1.568; p<0.001), age ≥75 years [OR=3.218; 95%CI=1.645-6.295; p=0.001] and diabetes mellitus [OR=1.670; 95%CI=1.091-2.557; p=0.018] were independent predictors of high rSS. The receiver-operating characteristic curve analysis demonstrated that the CHA2DS2-VASc score had good predictive value for high rSS with a cut-off value of 1.5 (area under curve (AUC): 0.611, 95% confidence interval (CI):0.562-0.659, p<0.001).
The CHA2DS2-VASc score has a predictive value on rSS in patients with STEMI. The CHA2DS2-VASc score was also an independent predictor of higher rSS.
CHA2DS2-VASc 评分与心血管疾病患者的不良临床结局相关。残余 Syntax 评分（rSS）是一种在 ST 段抬高型心肌梗死（STEMI）患者中具有预后价值的评分工具。
本研究旨在探讨 CHA2DS2-VASc 评分对 STEMI 患者 rSS 的预测价值。
共评估了 688 例连续接受经皮冠状动脉介入治疗的 STEMI 患者。评估了基线人口统计学和临床变量以及 CHA2DS2-VASc 评分。患者被分为两组；rSS 为 8 或以下的患者为组 1（509 例），rSS 大于 8 的患者为组 2（179 例）。p 值<0.05 被认为具有统计学意义。
组 2 的 CHA2DS2-VASc 评分较高[1（0-2）；1（1-3），p<0.001]。组 2 高血压[151（29.7%）；73（40.8%），p=0.006]、年龄≥75 岁[18（3.5%）；21（11.7%），p<0.001]、糖尿病[85（16.7%）；50（27.9%），p=0.001]和血管疾病[12（2.4%）；11（6.1%），p=0.029]的发生率较高。多变量逻辑回归分析显示，CHA2DS2-VASc 评分（OR=1.355；95%CI=1.171-1.568；p<0.001）、年龄≥75 岁（OR=3.218；95%CI=1.645-6.295；p=0.001）和糖尿病（OR=1.670；95%CI=1.091-2.557；p=0.018）是 rSS 较高的独立预测因素。受试者工作特征曲线分析表明，CHA2DS2-VASc 评分对 rSS 具有良好的预测价值，截断值为 1.5（曲线下面积（AUC）：0.611，95%置信区间（CI）：0.562-0.659，p<0.001）。
CHA2DS2-VASc 评分对 STEMI 患者的 rSS 具有预测价值。CHA2DS2-VASc 评分也是 rSS 较高的独立预测因素。
