Use of CHADS2and CHA2DS2-VASc scores to predict subsequent myocardial infarction, stroke, and death in patients with acute coronary syndrome

Data from taiwan acute coronary syndrome full spectrum registry

Su Kiat Chua, Huey Ming Lo, Chiung Zuan Chiu, Kou Gi Shyu

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Acute coronary syndrome (ACS) patients have a wide spectrum of risks for subsequent cardiovascular events and death. However, there is no simple, convenience scoring system to identify risk of adverse outcomes. We investigated whether CHADS2 and CHA2 DS2-VASc scores were useful tools to assess the risk for adverse events among ACS patients. Methods: This observational prospective study was conducted at 39 hospitals. Totally 3,183 patients with ACS were enrolled, and CHADS2 and CHA2DS2-VASc scores were calculated. The primary endpoint was occurrence of adverse event, including subsequent myocardial infarction, stroke, or death, within 1 year of discharge. Results: CHADS2 and CHA2DS2-VASc scores were significant predictors of adverse events in separate multivariate regression analyses. A Kaplan-Meier analysis of CHADS2 and CHA2DS2-VASc scores of ≥2 showed a higher rate of adverse events as compared with scores of 〈2 (P〈0.001;log-rank test). CHA2DS2-VASc score was better than CHADS 2 score in predicting subsequent adverse events; the area under the receiver operating characteristic curve increased from 0.66 to 0.70 (p〈 0.001). Patients with CHADS2 scores of 0 or 1 were further classified according to CHA2DS2-VASc score, using a cutoff value of 2. The rate of adverse events significantly differed between those with a score of 〈2 and those with a score of ≥2 (4.1% vs.10.7%, P〈0.001). Conclusions: CHADS2 and CHA2DS2-VASc scores were useful predictors of subsequent adverse events in ACS patients.

Original languageEnglish
Article numbere111167
JournalPLoS One
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 24 2014

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myocardial infarction
Acute Coronary Syndrome
Taiwan
stroke
Registries
Stroke
Myocardial Infarction
death
Kaplan-Meier Estimate
prospective studies
endpoints
ROC Curve
Observational Studies
Multivariate Analysis
Regression Analysis
Prospective Studies
testing

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Use of CHADS2and CHA2DS2-VASc scores to predict subsequent myocardial infarction, stroke, and death in patients with acute coronary syndrome : Data from taiwan acute coronary syndrome full spectrum registry. / Chua, Su Kiat; Lo, Huey Ming; Chiu, Chiung Zuan; Shyu, Kou Gi.

In: PLoS One, Vol. 9, No. 10, e111167, 24.10.2014.

Research output: Contribution to journalArticle

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abstract = "Background: Acute coronary syndrome (ACS) patients have a wide spectrum of risks for subsequent cardiovascular events and death. However, there is no simple, convenience scoring system to identify risk of adverse outcomes. We investigated whether CHADS2 and CHA2 DS2-VASc scores were useful tools to assess the risk for adverse events among ACS patients. Methods: This observational prospective study was conducted at 39 hospitals. Totally 3,183 patients with ACS were enrolled, and CHADS2 and CHA2DS2-VASc scores were calculated. The primary endpoint was occurrence of adverse event, including subsequent myocardial infarction, stroke, or death, within 1 year of discharge. Results: CHADS2 and CHA2DS2-VASc scores were significant predictors of adverse events in separate multivariate regression analyses. A Kaplan-Meier analysis of CHADS2 and CHA2DS2-VASc scores of ≥2 showed a higher rate of adverse events as compared with scores of 〈2 (P〈0.001;log-rank test). CHA2DS2-VASc score was better than CHADS 2 score in predicting subsequent adverse events; the area under the receiver operating characteristic curve increased from 0.66 to 0.70 (p〈 0.001). Patients with CHADS2 scores of 0 or 1 were further classified according to CHA2DS2-VASc score, using a cutoff value of 2. The rate of adverse events significantly differed between those with a score of 〈2 and those with a score of ≥2 (4.1{\%} vs.10.7{\%}, P〈0.001). Conclusions: CHADS2 and CHA2DS2-VASc scores were useful predictors of subsequent adverse events in ACS patients.",
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AU - Shyu, Kou Gi

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N2 - Background: Acute coronary syndrome (ACS) patients have a wide spectrum of risks for subsequent cardiovascular events and death. However, there is no simple, convenience scoring system to identify risk of adverse outcomes. We investigated whether CHADS2 and CHA2 DS2-VASc scores were useful tools to assess the risk for adverse events among ACS patients. Methods: This observational prospective study was conducted at 39 hospitals. Totally 3,183 patients with ACS were enrolled, and CHADS2 and CHA2DS2-VASc scores were calculated. The primary endpoint was occurrence of adverse event, including subsequent myocardial infarction, stroke, or death, within 1 year of discharge. Results: CHADS2 and CHA2DS2-VASc scores were significant predictors of adverse events in separate multivariate regression analyses. A Kaplan-Meier analysis of CHADS2 and CHA2DS2-VASc scores of ≥2 showed a higher rate of adverse events as compared with scores of 〈2 (P〈0.001;log-rank test). CHA2DS2-VASc score was better than CHADS 2 score in predicting subsequent adverse events; the area under the receiver operating characteristic curve increased from 0.66 to 0.70 (p〈 0.001). Patients with CHADS2 scores of 0 or 1 were further classified according to CHA2DS2-VASc score, using a cutoff value of 2. The rate of adverse events significantly differed between those with a score of 〈2 and those with a score of ≥2 (4.1% vs.10.7%, P〈0.001). Conclusions: CHADS2 and CHA2DS2-VASc scores were useful predictors of subsequent adverse events in ACS patients.

AB - Background: Acute coronary syndrome (ACS) patients have a wide spectrum of risks for subsequent cardiovascular events and death. However, there is no simple, convenience scoring system to identify risk of adverse outcomes. We investigated whether CHADS2 and CHA2 DS2-VASc scores were useful tools to assess the risk for adverse events among ACS patients. Methods: This observational prospective study was conducted at 39 hospitals. Totally 3,183 patients with ACS were enrolled, and CHADS2 and CHA2DS2-VASc scores were calculated. The primary endpoint was occurrence of adverse event, including subsequent myocardial infarction, stroke, or death, within 1 year of discharge. Results: CHADS2 and CHA2DS2-VASc scores were significant predictors of adverse events in separate multivariate regression analyses. A Kaplan-Meier analysis of CHADS2 and CHA2DS2-VASc scores of ≥2 showed a higher rate of adverse events as compared with scores of 〈2 (P〈0.001;log-rank test). CHA2DS2-VASc score was better than CHADS 2 score in predicting subsequent adverse events; the area under the receiver operating characteristic curve increased from 0.66 to 0.70 (p〈 0.001). Patients with CHADS2 scores of 0 or 1 were further classified according to CHA2DS2-VASc score, using a cutoff value of 2. The rate of adverse events significantly differed between those with a score of 〈2 and those with a score of ≥2 (4.1% vs.10.7%, P〈0.001). Conclusions: CHADS2 and CHA2DS2-VASc scores were useful predictors of subsequent adverse events in ACS patients.

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