title: Usefulness of the CHA2DS2-VASC Score to Predict Adverse Outcomes in Patients Having Percutaneous Coronary Intervention.
abstract: The application of the CHA2DS2-VASC score as a novel risk stratification tool for predicting outcome in clinical applications other than atrial fibrillation and stroke prevention has been previously examined. However, its usefulness in a population of patients with coronary artery disease after percutaneous coronary intervention (PCI) has not been explored. We investigated 12,785 consecutive patients who underwent PCI in a tertiary medical center from April 2004 to August 2014 (mean follow-up 6.5 years) and computed the CHA2DS2-VASC score on their index PCI. We assessed the relation between the CHA2DS2-VASC score and clinical outcomes (for example, all-cause mortality and mortality or myocardial infarction) at 1 and 5 years. The mean CHA2DS2-VASC score was 3.7 ± 1.7, 59.1% of patients obtained a score of 3 to 5. Both the primary and secondary outcomes at 1 and 5 years were significantly more frequent as the CHA2DS2-VASC score increased. Overall, the mortality rate after PCI was 10 times higher for patients with a CHA2DS2-VASC score of 5 compared with a score of 1 at both 1-and 5-year follow-up. The CHA2DS2-VASC score predicted all-cause mortality and death or nonfatal myocardial infarction in a significant (p <0.001, C-index 0.73 and 0.72) and linear fashion. In conclusion, the CHA2DS2-VASC score can be used as a simple and effective tool to predict long-term clinical outcomes in patients undergoing PCI.
authors.affiliation: Cardiology Department, Rabin Medical Center, Petach-Tikva, "Sackler" Faculty of Medicine, Tel-Aviv University, Israel. Electronic address: katiaorvin@gmail.com.
authors.forename: Katia
authors.initials: K
authors.lastname: Orvin
authors.affiliation: Cardiology Department, Rabin Medical Center, Petach-Tikva, "Sackler" Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Tamir
authors.initials: T
authors.lastname: Bental
authors.affiliation: Cardiology Department, Rabin Medical Center, Petach-Tikva, "Sackler" Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Abid
authors.initials: A
authors.lastname: Assali
authors.affiliation: Cardiology Department, Rabin Medical Center, Petach-Tikva, "Sackler" Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Eli Israel
authors.initials: EI
authors.lastname: Lev
authors.affiliation: Cardiology Department, Rabin Medical Center, Petach-Tikva, "Sackler" Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Hana
authors.initials: H
authors.lastname: Vaknin-Assa
authors.affiliation: Cardiology Department, Rabin Medical Center, Petach-Tikva, "Sackler" Faculty of Medicine, Tel-Aviv University, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome