title: The CHA2DS2VASc score can be used to stratify the prognosis of acute myocardial infarction patients irrespective of presence of atrial fibrillation.
abstract: BACKGROUND
  The CHA2DS2VASc score has been used to evaluate the risk of thromboembolic events in atrial fibrillation. However, because all the components of CHA2DS2VASc are important cardiovascular risk factors, we decided to evaluate the effectiveness of CHA2DS2VASc score as a long-term predictor for prognosis in acute myocardial infarction (AMI) patients.
  
  
  METHODS
  We enrolled 15,681 AMI patients for the Korean Working Group in Acute Myocardial Infarction (KORMI) consecutively and analyzed retrospectively. We divided the all the patients into four groups according to CHADS2VASc score (Group I: 0-1, n=3317; Group II: 2-3, n=6794; Group III: 4-5, n=4457; Group IV: 6-9, n=1113). The cardiac event was defined as the sum of all-cause mortality and recurrence of myocardial infarction.
  
  
  RESULTS
  As the risk score increased, the incidence of cardiac events was higher at 1, 6, 12, and 24 months. The cardiac event-free survival rate was lower as the risk score increased (Group I vs Group II, p<0.001; Group II vs Group III, p<0.001; Group III vs Group IV, p=0.037). After adjusting confounding variables, the Cox-regression multivariate analysis showed that the CHA2DS2VASc score was an independent predictor for the long-term prognosis in total AMI patients (p<0.001, hazard ratio=1.414 per scale).
  
  
  CONCLUSIONS
  The AMI patients with higher CHA2DS2VASc score had worse cardiovascular outcome. Therefore, CHADS2VASc score can be used to stratify AMI patients according to long-term prognosis irrespective of presence of atrial fibrillation.
authors: Division of Cardiology, Department of Internal Medicine, Gwangju Veterans Hospital, Gwangju, Republic of Korea.
authors: Kyung Hwan
authors: KH
authors: Kim
authors: Division of Cardiology, Department of Internal Medicine, Gwangju Veterans Hospital, Gwangju, Republic of Korea.
authors: Wan
authors: W
authors: Kim
authors: Division of Cardiology, Department of Internal Medicine, Gwangju Veterans Hospital, Gwangju, Republic of Korea. Electronic address: omoegao@hanmail.net.
authors: Sun Ho
authors: SH
authors: Hwang
authors: Division of Cardiology, Department of Internal Medicine, Gwangju Veterans Hospital, Gwangju, Republic of Korea.
authors: Won Yu
authors: WY
authors: Kang
authors: Division of Cardiology, Department of Internal Medicine, Gwangju Veterans Hospital, Gwangju, Republic of Korea.
authors: Sang Cheol
authors: SC
authors: Cho
authors: Department of Cardiovascular Medicine, Kyunghee University College of Medicine, Seoul, Republic of Korea.
authors: Weon
authors: W
authors: Kim
authors: Department of Cardiovascular Medicine, Chonnam National College of Medicine, Gwangju, Republic of Korea.
authors: Myung Ho
authors: MH
authors: Jeong
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000145:classification / Q000401:mortality*; D011379:Prognosis; D012008:Recurrence; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Acute myocardial infarction; CHA(2)DS(2)VASc score; Major adverse cardiac event