Predictive Value of CHA2DS2-VASc Score for Ischemic Events in Patients Undergoing Percutaneous Coronary Intervention

Angiology ◽  
2018 ◽  
Vol 70 (9) ◽  
pp. 878-886 ◽  
Author(s):  
Xiaoyan Wang ◽  
Chongzhe Pei ◽  
Yingnan Bai ◽  
Qiying Dai ◽  
Xin Deng ◽  
...  
Keyword(s):  
Heart Failure ◽  
Percutaneous Coronary Intervention ◽  
Cardiac Death ◽  
Coronary Intervention ◽  
Chronic Obstructive ◽  
Digital Repository ◽  
Obstructive Pulmonary Disease ◽  
Percutaneous Coronary ◽  
Ischemic Events

We evaluated the association of preprocedure CHA2DS2-VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke, vascular disease, and sex) score with ischemic events in patients undergoing percutaneous coronary intervention (PCI). The Dryad Digital Repository enrolled 2533 patients between July 2009 and August 2011. We recorded 1-year ischemic events. Univariate and multivariable logistic regression analyses were used to analyze the association between CHA2DS2-VASc score and ischemic events. Receiver operating characteristic curves were used to evaluate the accuracy of CHA2DS2-VASc score in predicting long-term ischemic events. Long-term death (9.5 vs 2.8%), cardiac death (2.9 vs 1.4%), and nonfatal stroke (1.9 vs 0.7%) were significantly higher in the CHA2DS2-VASc score ≥2 group than the CHA2DS2-VASc score ≤1 group. The CHA2DS2-VASc score was a predictor for all-cause death (odds ratio [95% confidence interval]: 3.71 [1.89-7.30]). The risk factors for all-cause death in CHA2DS2-VASc score ≥2 patients included age, diagnosis, heart failure, older myocardial infarction, diabetes, and chronic obstructive pulmonary disease, while the risk factor for CHA2DS2-VASc score ≤1 patients was age. In conclusion, the CHA2DS2-VASc score is associated with long-term all-cause death, cardiac death, and stroke in patients undergoing PCI, and it may have a potential use for risk stratification for patients who undergo PCI.

scholarly journals Impact of Chronic Obstructive Pulmonary Disease on Long-Term Outcome in Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ming Zhang ◽  
Yun-Jiu Cheng ◽  
Wei-ping Zheng ◽  
Guang-Hui Liu ◽  
Huai-Sheng Chen ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Death ◽  
Coronary Intervention ◽  
Cox Proportional Hazards ◽  
Chronic Obstructive ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Percutaneous Coronary ◽  
History Of

Objective. The aim of this study was to investigate the association between COPD and major adverse cardiovascular and cerebral events (MACCE) in patients undergoing percutaneous coronary intervention (PCI).Methods. 2,362 patients who underwent PCI were included in this study. Subjects were divided into 2 groups: with COPD (n=233) and without COPD (n= 2,129). Cox proportional hazards models were analyzed to determine the effect of COPD on the incidence of MACCE.Results. The patients with COPD were older (P<0.0001) and were more likely to be current smokers (P=0.02) and have had hypertension (P=0.02) and diabetes mellitus (P=0.01). Prevalence of serious cardiovascular comorbidity was higher in the patients with COPD, including a history of MI (P=0.02) and HF (P<0.0001). Compared with non-COPD group, the COPD group showed a higher risk of all-cause death (hazard ratio (HR): 2.45,P<0.0001), cardiac death (HR: 2.53,P=0.0002), MI (HR: 1.387,P=0.027), and HF (HR: 2.25,P<0.0001).Conclusions. Patients with CAD and concomitant COPD are associated with a higher incidence of MACCE (all-cause death, cardiac death, MI, and HF) compared to patients without COPD. The patients with a history of COPD have higher in-hospital and long-term mortality rates than those without COPD after PCI.

scholarly journals A Novel Multiple Risk Score Model for Prediction of Long-Term Ischemic Risk in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: Insights From the I-LOVE-IT 2 Trial

2022 ◽  
Vol 8 ◽  
Author(s):  
Miaohan Qiu ◽  
Yi Li ◽  
Kun Na ◽  
Zizhao Qi ◽  
Sicong Ma ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Death ◽  
Coronary Intervention ◽  
Risk Scores ◽  
Percutaneous Coronary ◽  
Multiple Risk ◽  
Artery Disease ◽  
Score Model ◽  
Ischemic Events

Backgrounds: A plug-and-play standardized algorithm to identify the ischemic risk in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) could play a valuable step to help a wide spectrum of clinic workers. This study intended to investigate the ability to use the accumulation of multiple clinical routine risk scores to predict long-term ischemic events in patients with CAD undergoing PCI.Methods: This was a secondary analysis of the I-LOVE-IT 2 (Evaluate Safety and Effectiveness of the Tivoli drug-eluting stent (DES) and the Firebird DES for Treatment of Coronary Revascularization) trial, which was a prospective, multicenter, and randomized study. The Global Registry for Acute Coronary Events (GRACE), baseline Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX), residual SYNTAX, and age, creatinine, and ejection fraction (ACEF) score were calculated in all patients. Risk stratification was based on the number of these four scores that met the established thresholds for the ischemic risk. The primary end point was ischemic events at 48 months, defined as the composite of cardiac death, nonfatal myocardial infarction, stroke, or definite/probable stent thrombosis (ST).Results: The 48-month ischemic events had a significant trend for higher event rates (from 6.61 to 16.93%) with an incremental number of risk scores presenting the higher ischemic risk from 0 to ≥3 (p trend &lt; 0.001). In addition, the categories were associated with increased risk for all components of ischemic events, including cardiac death (from 1.36 to 3.15%), myocardial infarction (MI) (from 3.31 to 9.84%), stroke (3.31 to 6.10%), definite/probable ST (from 0.58 to 1.97%), and all-cause mortality (from 2.14 to 6.30%) (all p trend &lt; 0.05). The net reclassification index after combined with four risk scores was 12.5% (5.3–20.0%), 9.4% (2.0–16.8%), 12.1% (4.5–19.7%), and 10.7% (3.3–18.1%), which offered statistically significant improvement in the performance, compared with SYNTAX, residual SYNTAX, ACEF, and GRACE score, respectively.Conclusion: The novel multiple risk score model was significantly associated with the risk of long-term ischemic events in these patients with an increment of scores. A meaningful improvement to predict adverse outcomes when multiple risk scores were applied to risk stratification.

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