title: Usefulness of the CHADS2 score for prognostic stratification of patients with acute myocardial infarction.
abstract: The Thrombolysis In Myocardial Infarction (TIMI) score and Global Registry of Acute Coronary Events (GRACE) score have been validated as predictors of major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI). This study was undertaken to determine whether the CHADS2 score had good accuracy for predicting clinical outcome in patients with AMI and to compare the discriminatory performance of the 3 risk scores (RSs). We calculated the TIMI RS, GRACE RS, and CHADS2 score for 747 consecutive patients with AMI. The study end point was the combined occurrence of MACE, including death, nonfatal myocardial infarction, and ischemic stroke. All patients were followed up for at least 3 years or until the occurrence of a major event. The area under the receiver operating characteristic curve was used to evaluate the predictive ability of each score at different time points. Higher CHADS2 scores were associated with adverse outcome at discharge and 1-year and 3-year follow-ups (chi-square test for linear trend, p <0.001). Both CHADS2 score and GRACE RS demonstrated better discrimination than TIMI RS in predicting 1-year and 3-year MACE (p <0.001). Multivariate Cox regression analysis revealed that the CHADS2 score was an independent predictor of future MACE in patients with AMI (hazard ratio 1.349, 95% confidence interval 1.196 to 1.522). In conclusion, the CHADS2 score provides potentially valuable prognostic information on clinical outcome when applied to patients with AMI.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shao-Sung
authors.initials: SS
authors.lastname: Huang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ying-Hwa
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Wan-Leong
authors.initials: WL
authors.lastname: Chan
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: huangbs@vghtpe.gov.tw.
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Huang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan; Institute and Department of Pharmacology, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D015912:Thrombolytic Therapy / Q000379:methods; D014057:Tomography, X-Ray Computed; D019210:Troponin I / Q000097:blood
chemical_list: D005343:Fibrinolytic Agents; D019210:Troponin I