Predictive value of newly defined CHA2DS2-VASc-HSF score for severity of coronary artery disease in ST segment elevation myocardial infarction

Abstract

Background: CHADS2 and CHA2DS2-VASc scores are widely used in clinical practice and include similar risk factors for the development of coronary artery disease (CAD). It is known that the factors comprising the newly defined CHA2DS2-VASc-HSF score promote atherosclerosis and are associated with severity of CAD.

Aim: To investigate the association of the CHA2DS2-VASc-HSF score with the severity of CAD as assessed by SYNTAX score (SxS) in patients with ST segment elevation myocardial infarction (STEMI).

Methods: A total of 454 consecutive patients with STEMI (males 79%, mean age 57.3 ± 12.9 years), who underwent primary percutaneous coronary intervention were included in our study. The patients were divided into three groups according to the SxS tertiles: low SxS group (SxS < 14; 151 patients), intermediate SxS group (SxS 14–20; 152 patients), and high SxS group (SxS ≥ 21; 151 patients).

Results: The CHADS2, CHA2DS2-VASc, and CHA2DS2VASc-HSF scores were found to be significantly different among the SxS groups (p < 0.001, p < 0.001, and p < 0.001). After multivariate analysis, the CHA2DS2-VASc-HSF score was associated with high SxS (odds ratio [OR] 1.258, 95% confidence interval [CI] 1.026–1.544; p = 0.028) together with age (OR 1.032, 95% CI 1.013–1.050; p = 0.001) and ejection fraction (OR 0.927, 95% CI 0.901–0.955; p < 0.001).

Conclusions: A newly diagnosed CHA2DS2-VASc-HSF score predicts the severity of atherosclerosis in patients with STEMI.