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Evaluation of CHA2DS2-VASc and ATRIA scores in patients with ST-elevation myocardial infarction

Year 2019, Volume: 10 Issue: 4, 377 - 380, 13.12.2019

Abstract

Objective: CHA2DS2-VASc and ATRIA scores are a valid, practical
method for the risk classification of thromboembolic complications due to
atrial fibrillation. The aim of this study was to evaluate the use of
CHA2DS2-VASC and ATRIA scores in predicting high-risk patients with coronary
artery disease.

Patients and methods: Between May 2015 and Jan 2016, 432 patients who were
followed up with a diagnosis of myocardial infarction with ST elevation were
included in the study. Baseline demographic characteristics, ATRIA,
CHA2DS2-VASC and SYNTAX scores were calculated. The patients were divided into two
groups according to the low and medium-high SYNTAX score.

Results: 20% of the patients had moderate to high SYNTAX score and 25.9% were
female. The mean age of the patients was 63.9 ± 13.7 (28-91) years.
CHA2DS2-VASC score and ATRIA score were significantly higher in patients with moderate-to-high
SYNTAX score than in patients with low SYNTAX score (2.0 ± 1.4 versus 2.4 ±
1.5; p = 0.014 and  3.2 ± 2.8 versus 4.2
± 2; p = 0.009, respectively). In the correlation analysis, there was a
positive correlation between the SYNTAX score and the CHA2DS2-VASC and ATRIA
scores. In addition, in the single regression analysis, the CHA2DS2-VASC and
ATRIA scores predicted patients with moderate to high SYNTAX scores.







Conclusion: ATRIA and CHA2DS2-VASc scores are the scoring systems
that can be used in coronary artery prevalence. The use of STEMI patients in
the evaluation of high-risk patients may be recommended.

References

  • 1. Piché M-E, Poirier P, Lemieux I, Després J-P. Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: an update. Progress in cardiovascular diseases. 2018.
  • 2. Andersson C, Vasan RS. Epidemiology of cardiovascular disease in young individuals. Nature Reviews Cardiology. 2018; 15(4): 230.
  • 3. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016; 37(38): 2893-962.
  • 4. Singer DE, Chang Y, Borowsky LH, Fang MC, Pomernacki NK, Udaltsova N, et al. A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score. Journal of the American Heart Association. 2013; 2(3): e000250.
  • 5. Aksoy F, Guler S, Kahraman F, Oskay T, Varol E. The Relation Between Echocardiographic Epicardial Fat Thickness and CHA2DS2-VASc Score in Patients with Sinus Rhythm. Brazilian journal of cardiovascular surgery. 2019; 34(1): 41-7.
  • 6. Çetinkal G, Koçaş C, Koçaş BB, Arslan Ş, Abacı O, Karaca OŞ, et al. Comparative performance of AnTicoagulation and Risk factors In Atrial fibrillation and Global Registry of Acute Coronary Events risk scores in predicting long-term adverse events in patients with acute myocardial infarction. Anatolian journal of cardiology. 2018; 20(2): 77.
  • 7. Serruys PW, Onuma Y, Garg S, Sarno G, van den Brand M, Kappetein A-P, et al. Assessment of the SYNTAX score in the Syntax study. EuroIntervention. 2009; 5(1): 50-6.
  • 8. Cetin M, Cakici M, Zencir C, Tasolar H, Baysal E, Balli M, et al. Prediction of coronary artery disease severity using CHADS2 and CHA2DS2-VASc scores and a newly defined CHA2DS2-VASc-HS score. The American journal of cardiology. 2014; 113(6): 950-6.
  • 9. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European heart journal. 2017; 39(2): 119-77.
  • 10. Tang EW, Wong C-K, Herbison P. Global Registry of Acute Coronary Events (GRACE) hospital discharge risk score accurately predicts long-term mortality post acute coronary syndrome. American heart journal. 2007; 153(1): 29-35.
  • 11. Mrdovic I, Savic L, Krljanac G, Asanin M, Perunicic J, Lasica R, et al. Predicting 30-day major adverse cardiovascular events after primary percutaneous coronary intervention. The RISK-PCI score. International journal of cardiology. 2013; 162(3): 220-7.
  • 12. Roffi M, Patrono C, Collet J-P, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). European heart journal. 2016; 37(3): 267-315.

Akut Koroner Sendromu Olan Bireylerde CHA2DS2-VASc ve ATRIA Skorlarının Değerlendirilmesi

Year 2019, Volume: 10 Issue: 4, 377 - 380, 13.12.2019

Abstract

Amaç:
CHA2DS2-VASc ve ATRIA skorları atriyal fibrilasyona bağlı tromboembolik
komplikasyonların risk sınıflandırmasında kullanılan geçerli, pratik bir
yöntemdir. Bu çalışmada CHA2DS2-VASC ve ATRIA skorlarının koroner arter
hastalığına sahip yüksek riskli hastaları ön görmedeki kullanımının
değerlendirilmesi amaçlanmıştır.



Hastalar
ve yöntem:
Çalışmaya 2015 Mayıs ayı ile 2016 Ocak ayları
arasında bir üniversite tıp fakültesi kardiyoloji ST elevasyonlu miyokart
enfarktüsü tanısı ile takip edilen 432 hasta dahil edilmiştir. Tüm hastaların
bazal demografik özellikleri değerlendirilmiş ATRIA, CHA2DS2-VASC ve SYNTAX
skorları hesaplanmıştır. Hastalar düşük ve orta-yüksek SYNTAX skoruna göre iki
gruba ayrılmıştır.



Bulgular:
Hastaların
%20’si orta-yüksek SYNTAX skoruna sahipti ve
%25,9’u kadındı. Hastaların yaş ortalaması ise
63,9±13,7 (28-91)’di. Orta-yüksek
SYNTAX skoruna sahip
olan hastaların ortalama CHA2DS2-VASC(
2,0±1,4
ve 2,4±1,5; p=0,014)
ve ATRIA skorları (3,2±2,8 ve 4,2±2,8; p=0,009)
 düşük SYNTAX grubuna sahip hastalara
göre anlamlı olarak yüksekti. Yapılan korelasyon analizinde ise SYNTAX skoru
ile CHA2DS2-VASC ve ATRIA skorları arasında pozitif korelasyon mevcuttu. Ayrıca
yapılan tekli regresyon analizinde CHA2DS2-VASC ve ATRIA skorları orta-yüksek
SYNTAX skoruna sahip hastaları öngörmekteydi.



Sonuç:
ATRIA
ve CHA2DS2-VASc skorları koroner arter yaygınlığında
kullanılabilen yatak başında hızlıca değerlendirilen skorlama sistemleridir.
STEMI hastalarında yüksek riskli hastaların değerlendirilmesinde kullanımı
önerilebilir. 

References

  • 1. Piché M-E, Poirier P, Lemieux I, Després J-P. Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: an update. Progress in cardiovascular diseases. 2018.
  • 2. Andersson C, Vasan RS. Epidemiology of cardiovascular disease in young individuals. Nature Reviews Cardiology. 2018; 15(4): 230.
  • 3. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016; 37(38): 2893-962.
  • 4. Singer DE, Chang Y, Borowsky LH, Fang MC, Pomernacki NK, Udaltsova N, et al. A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score. Journal of the American Heart Association. 2013; 2(3): e000250.
  • 5. Aksoy F, Guler S, Kahraman F, Oskay T, Varol E. The Relation Between Echocardiographic Epicardial Fat Thickness and CHA2DS2-VASc Score in Patients with Sinus Rhythm. Brazilian journal of cardiovascular surgery. 2019; 34(1): 41-7.
  • 6. Çetinkal G, Koçaş C, Koçaş BB, Arslan Ş, Abacı O, Karaca OŞ, et al. Comparative performance of AnTicoagulation and Risk factors In Atrial fibrillation and Global Registry of Acute Coronary Events risk scores in predicting long-term adverse events in patients with acute myocardial infarction. Anatolian journal of cardiology. 2018; 20(2): 77.
  • 7. Serruys PW, Onuma Y, Garg S, Sarno G, van den Brand M, Kappetein A-P, et al. Assessment of the SYNTAX score in the Syntax study. EuroIntervention. 2009; 5(1): 50-6.
  • 8. Cetin M, Cakici M, Zencir C, Tasolar H, Baysal E, Balli M, et al. Prediction of coronary artery disease severity using CHADS2 and CHA2DS2-VASc scores and a newly defined CHA2DS2-VASc-HS score. The American journal of cardiology. 2014; 113(6): 950-6.
  • 9. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European heart journal. 2017; 39(2): 119-77.
  • 10. Tang EW, Wong C-K, Herbison P. Global Registry of Acute Coronary Events (GRACE) hospital discharge risk score accurately predicts long-term mortality post acute coronary syndrome. American heart journal. 2007; 153(1): 29-35.
  • 11. Mrdovic I, Savic L, Krljanac G, Asanin M, Perunicic J, Lasica R, et al. Predicting 30-day major adverse cardiovascular events after primary percutaneous coronary intervention. The RISK-PCI score. International journal of cardiology. 2013; 162(3): 220-7.
  • 12. Roffi M, Patrono C, Collet J-P, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). European heart journal. 2016; 37(3): 267-315.
There are 12 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Article
Authors

Ali Bağcı 0000-0002-8792-6329

Fatih Aksoy 0000-0002-6480-4935

Publication Date December 13, 2019
Submission Date April 10, 2019
Published in Issue Year 2019 Volume: 10 Issue: 4

Cite

Vancouver Bağcı A, Aksoy F. Akut Koroner Sendromu Olan Bireylerde CHA2DS2-VASc ve ATRIA Skorlarının Değerlendirilmesi. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2019;10(4):377-80.

SDÜ Sağlık Bilimleri Dergisi, makalenin gönderilmesi ve yayınlanması dahil olmak üzere hiçbir aşamada herhangi bir ücret talep etmemektedir. Dergimiz, bilimsel araştırmaları okuyucuya ücretsiz sunmanın bilginin küresel paylaşımını artıracağı ilkesini benimseyerek, içeriğine anında açık erişim sağlamaktadır.