Allam Hager, Mostafa Shaimaa, Abd Khalek El-Sayed, Abdalla Sara
Cardiology Department, Faculty of Medicine, Benha University, Benha, Egypt.
Cardiology Department, Faculty of Medicine, Benha University, Benha, Egypt.
Indian Heart J. 2025 Jan-Feb;77(1):1-6. doi: 10.1016/j.ihj.2024.12.001. Epub 2024 Dec 21.
Future clinical management would be improved by accurate and early identification of ACS patients at high CV risk. In non-valvular atrial fibrillation patients, the prognostic risk of thromboembolism has been evaluated using CHA₂DS₂-VASc scores. It has recently been shown to assess the severity of CAD and foresee patient outcomes. Also, LV global longitudinal strain is an independent predictor of outcome. Our study aimed to determine the added value of LV longitudinal strain (GLS) to CHA₂DS₂-VASc in predicting the outcome and severity of CAD in patients with acute coronary syndrome (ACS).
A total of 577 patients with primary diagnosis of ACS were included between January and July 2021. All patients had evaluations based on history, clinical examination, 12-lead ECG, TTE, and coronary angiography. Six months follow-up had been provided to all patients.
Syntax score was significantly higher among patients with high-risk CHA₂DS₂-VASc score (30.5 ± 6.1 vs. 17.34 ± 8.7 vs. 11.11 ± 8.2), p-value <0. 001. GLS was significantly lower among high SYNTAX score (-10.97 ± 2.68 vs. -12.61 ± 3.46 vs. -17.81 ± 2.89), p-value = 0.0001. There was a significant negative correlation between the CHA₂DS₂-VASc score and GLS. Moreover, adding GLS to CHA₂DS₂-VASc score significantly improved overall accuracy for the prediction of outcome and severity of CAD in ACS patients.
CHA₂DS₂-VASc score is an easy and simple parameter that can be used in predicting the severity of CAD & adverse clinical outcome in ACS patients and adding GLS to the CHA₂DS₂-VASc score significantly improved overall accuracy.
准确且早期识别具有高心血管风险的急性冠状动脉综合征（ACS）患者，将有助于改善未来的临床管理。在非瓣膜性心房颤动患者中，已使用CHA₂DS₂-VASc评分评估血栓栓塞的预后风险。最近研究表明，该评分可用于评估冠状动脉疾病（CAD）的严重程度并预测患者预后。此外，左心室整体纵向应变是预后的独立预测指标。我们的研究旨在确定左心室纵向应变（GLS）对CHA₂DS₂-VASc评分在预测急性冠状动脉综合征（ACS）患者CAD预后和严重程度方面的附加价值。
纳入2021年1月至7月期间初次诊断为ACS的577例患者。所有患者均根据病史、临床检查、12导联心电图、经胸超声心动图（TTE）和冠状动脉造影进行评估。所有患者均接受了6个月的随访。
CHA₂DS₂-VASc高危评分患者的Syntax评分显著更高（分别为30.5 ± 6.1、17.34 ± 8.7和11.11 ± 8.2），p值<0.001。Syntax高分患者的GLS显著更低（分别为-10.97 ± 2.68、-12.61 ± 3.46和-17.81 ± 2.89），p值 = 0.0001。CHA₂DS₂-VASc评分与GLS之间存在显著负相关。此外，将GLS添加到CHA₂DS₂-VASc评分中可显著提高预测ACS患者CAD预后和严重程度的总体准确性。
CHA₂DS₂-VASc评分是一个简单易用的参数，可用于预测ACS患者CAD的严重程度和不良临床结局，将GLS添加到CHA₂DS₂-VASc评分中可显著提高总体准确性。
