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- W4313444037 abstract "Although the CHA2DS2-VASc score was originally used for stroke risk assessment in patients with atrial fibrillation, recently, its use has been extended to various cardiovascular diseases, including acute coronary syndrome (ACS). Since most of its components are widely accepted risk factors for coronary artery disease (CAD) development, we aimed to assess its accuracy in the determination of coronary atherosclerotic burden and its prognostic performance for adverse outcomes. This was a prospective observational single-center study. Consecutive ACS patients were enrolled. For prediction of CAD severity, patients were split into tertiles according to the Syntax score I (SSI). For prognosis, patients were divided into two groups and four subgroups according to the CHA2DS2-VASc score. Two composite adverse events were assessed: overall major adverse cardiovascular events (MACE) and all-cause mortality, in-hospital and after 1 year of follow-up. A total of 228 patients were enrolled. Of them, 6.14% had a high SSI. Compared to low tertile, the CHA2DS2-VASc score was significantly higher in intermediate and high SSI tertiles. Both scores correlated moderately (r = 0.315; P < 0.001). After multivariate analysis, the CHA2DS2-VASc score was the only predictor of high SSI (OR = 1.88; 95% CI: 1.12–3.17; P = 0.017). A CHA2DS2-VASc score ≥ 4 was a cut-off point for severe CAD with a sensitivity of 71.4% and specificity of 74.8%. As for prognosis, higher CHA2DS2-VASc score was associated with a significant increase in in-hospital MACE and death. Likewise, the risk of MACE and 1-year mortality significantly increased in higher subgroups. Following multivariate regression, the CHA2DS2-VASc score was an independent predictor for long-term prognosis (HR = 1.50; P < 0.001 for MACE; HR = 1.87; P < 0.001 for death). Finally, the CHA2DS2-VASc score was comparable to GRACE score with regard to in-hospital and long-term adverse outcomes. The CHA2DS2-VASc score was an independent predictor of severe coronary lesions as well as short and long-term adverse outcomes. Also, the prognostic accuracy of the CHA2DS2-VASc score for poor outcome was comparable with that of the GRACE score." @default.
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- W4313444037 date "2023-01-01" @default.
- W4313444037 modified "2023-09-26" @default.
- W4313444037 title "CHA2DS2-VASc score in acute coronary syndrome patients: Assessment of coronary atherosclerotic burden and prediction of adverse outcome" @default.
- W4313444037 doi "https://doi.org/10.1016/j.acvdsp.2022.10.029" @default.
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