Teodorovich Nicholay, Gandelman Gera, Jonas Michael, Fabrikant Yakov, Swissa Michael Sraia, Shimoni Sara, George Jacob, Swissa Moshe
Kaplan Medical Center, Rehovot and the Hebrew University, Jerusalem 7661041, Israel.
Shari-Zedek Medical Center, and the Hebrew University, Jerusalem 9103102, Israel.
Life (Basel). 2023 Oct 9;13(10):2026. doi: 10.3390/life13102026.
The CHADS-VAS score is used to predict the risk of thromboembolic complications in patients with atrial fibrillation (AF). We hypothesized that the CHADS-VAS score can be used to predict mortality in patients undergoing coronary angiography.
This was a prospective study of 990 patients undergoing coronary angiography. The median follow-up was 2294 days. The patients were categorized into two groups according to their CHADS-VAS score: group I had scores <4 and group II had scores ≥4 (527 (53.2%) and 463 (46.8%), respectively). A Kaplan-Meier analysis demonstrated a significant association between the CHADS-VAS score and mortality (69/527 (13.1%) vs. 179/463 (38.7%) for group I vs. group II, respectively, < 0.0001). The association remained significant in patients with and without AF, reduced and preserved LVEF, normal and reduced kidney function, and with and without ACS ( < 0.009 to < 0.0001 for all). In the Cox regression model, which combined the CHADS-VAS score, the presence of AF, LVEF, anemia, and renal insufficiency, an elevated CHADS-VAS score of ≥4 was independently associated with higher mortality (HR 2.12, CI 1.29-3.25, = 0.001).
The CHADSVAS score is a simple and reliable mortality predictor in patients undergoing coronary angiography and should be used for the initial screening for such patients.
CHADS-VAS评分用于预测心房颤动（AF）患者发生血栓栓塞并发症的风险。我们推测CHADS-VAS评分可用于预测接受冠状动脉造影术患者的死亡率。
这是一项对990例接受冠状动脉造影术患者的前瞻性研究。中位随访时间为2294天。根据CHADS-VAS评分将患者分为两组：I组评分<4分，II组评分≥4分（分别为527例（53.2%）和463例（46.8%））。Kaplan-Meier分析显示CHADS-VAS评分与死亡率之间存在显著关联（I组与II组分别为69/527例（13.1%）和179/463例（38.7%），P<0.0001）。在有或无AF、左心室射血分数降低或保留、肾功能正常或降低以及有或无急性冠状动脉综合征的患者中，这种关联仍然显著（所有P值均<0.009至<0.0001）。在Cox回归模型中，结合CHADS-VAS评分、AF的存在、左心室射血分数、贫血和肾功能不全，CHADS-VAS评分≥4升高与较高的死亡率独立相关（风险比2.12，可信区间1.29-3.25，P=0.001）。
CHADS-VAS评分是接受冠状动脉造影术患者简单可靠的死亡率预测指标，应用于此类患者的初步筛查。
