title: Predictive value of CHADS2 score for cardiovascular events in patients with acute coronary syndrome and documented coronary artery disease.
abstract: OBJECTIVE
  The CHADS2 score, used to predict the risk of ischemic stroke in atrial fibrillation (AF) patients, has been reported recently to predict ischemic stroke in patients with coronary heart disease, regardless of the presence of AF. However, little data are available regarding the relationship between the CHADS2 score and cardiovascular outcomes.
  
  
  METHODS
  This was a retrospective study on 104 patients admitted for acute coronary syndrome (ACS) who underwent coronary angiography, carotid ultrasound, and transthoracic echocardiography.
  
  
  RESULTS
  The mean age of the subjects was 60.1 ± 12.6 years. The CHADS2 score was as follows: 0 in 46 patients (44.2%), 1 in 31 (29.8%), 2 in 18 (17.3%), and ≥ 3 in 9 patients (8.7%). The left atrial volume index (LAVi) showed a positive correlation with the CHADS2 score (20.8 ± 5.9 for 0; 23.2 ± 6.7 for 1; 26.6 ± 10.8 for 2; and 30.3 ± 8.3 mL/m(2) for ≥3; p = 0.001). The average carotid total plaque area was significantly increased with CHADS2 scores ≥ 2 (4.97 ± 7.17 mm(2) vs. 15.52 ± 14.61 mm(2); p = 0.002). Eight patients experienced cardiovascular or cerebrovascular (CCV) events during a mean evaluation period of 662 days. A CHADS2 score ≥ 3 was related to an increase in the risk of CCV events (hazard ratio, 14.31; 95% confidence interval, 3.53 to 58.06). Furthermore, LAVi and the severity of coronary artery obstructive disease were also associated with an increased risk of CCV events.
  
  
  CONCLUSIONS
  The CHADS2 score may be a useful prognostic tool for predicting CCV events in ACS patients with documented coronary artery disease.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: In Sook
authors.initials: IS
authors.lastname: Kang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Wook Bum
authors.initials: WB
authors.lastname: Pyun
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Gil Ja
authors.initials: GJ
authors.lastname: Shin
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000000981:diagnostic imaging*; D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000209:etiology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003661:Decision Support Techniques; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
keywords: Acute coronary syndrome; Atherosclerosis; Risk factors