title: Higher CHA2DS2-VASc Score Is Associated With Increased Mortality in Acute Pulmonary Embolism.
abstract: BACKGROUND
  CHA2DS2-VASc score has been validated in risk prediction for stroke and thromboembolism in patients with atrial fibrillation (AF). Association of CHA2DS2-VASc score with higher risk of venous thromboembolism and pulmonary embolism (PE) has also been shown. In this study, we investigated the long-term prognostic value of CHA2DS2-VASc score in patients with acute pulmonary embolism (APE).
  
  
  METHODS
  Consecutive patients with APE presenting to our emergency department were retrospectively recruited. Patients with AF and who died secondary to causes other than PE were excluded from the study. The CHA2DS2-VASc score and pulmonary embolism severity index (PESI) were calculated.
  
  
  RESULTS
  Two hundred seventy seven participants were included in the study. The mortality rate was 18.7%. Twenty-two cases died within 30 days, and 30 cases died during the follow-up period (median: 13 months). The mean CHA2DS2-VASc score was significantly higher in dead patients compared to survivors (3.61 ± 1.35 vs 1.95 ± 1.52, P < .01). In multivariate regression analysis, systolic pulmonary artery pressure (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 1.01-1.06, P = .02), PESI score (HR: 1.010, 95% CI: 1.004-1.017, P < .01), and CHA2DS2-VASc score (HR: 1.67, 95% CI: 1.19-2.16, P < .01) were found to be independently correlated with mortality. The patients whose CHA2DS2-VASc score was between 1 and 3 had 5.67 times and patients whose CHA2DS2-VASc score was ≥4 had 16.8 times higher risk of mortality compared to patients with CHA2DS2-VASc score = 0.
  
  
  CONCLUSIONS
  Patients with higher CHA2DS2-VASc scores had higher rates of mortality after APE.
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Onuk
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Mehmet Baran
authors.initials: MB
authors.lastname: Karataş
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Göktürk
authors.initials: G
authors.lastname: İpek
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Barış
authors.initials: B
authors.lastname: Güngör
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Akyüz
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Yiğit
authors.initials: Y
authors.lastname: Çanga
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Ahmet Okan
authors.initials: AO
authors.lastname: Uzun
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: İlhan İlker
authors.initials: İİ
authors.lastname: Avcı
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Altuğ
authors.initials: A
authors.lastname: Ösken
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Hülya
authors.initials: H
authors.lastname: Kaşıkçıoğlu
authors.affiliation: 1 Department of Cardiology, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Neşe
authors.initials: N
authors.lastname: Çam
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D062186:Arterial Pressure; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000401:mortality*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index
keywords: CHA2DS2-VASc score; acute pulmonary embolism; mortality