Predictive Value of CHADS2, CHA2DS2-VASc and R2-CHADS2 Scores for Short- and Long-Term Major Adverse Cardiac Events in Non-ST-Segment Elevation Myocardial Infarction

Circ J. 2024 Jul 25;88(8):1246-1253. doi: 10.1253/circj.CJ-23-0733. Epub 2023 Dec 15.

Abstract

Background: Non-ST-elevation myocardial infarction (NSTEMI) carries a poor prognosis, and accurately prognostication has significant clinical importance. In this study, we analyzed the predictive value of the CHADS2, CHA2DS2-VASc, and R2-CHADS2scores for major adverse cardiac events (MACE) following percutaneous coronary intervention (PCI) in patients with NSTEMI using data from a prospective multicenter registry.

Methods and results: The registry included 440 consecutive patients with NSTEMI and coronary artery disease who underwent successful PCI. Patients were clinically followed for up to 3 years or until the occurrence of MACE. MACE was defined as a composite of all-cause death and nonfatal MI. During the follow-up period, 55 patients (12.5%) experienced MACE. Risk analysis of MACE occurrence, adjusted for the multivariable model, demonstrated a significant increase in risk with higher CHADS2, CHA2DS2-VASc, and R2-CHADS2scores. Kaplan-Meier analysis showed a higher incidence of MACE in patients with higher CHADS2, CHA2DS2-VASc, and R2-CHADS2scores, both in the short- and long-term periods.

Conclusions: Patients with NSTEMI and higher CHADS2, CHA2DS2-VASc, and R2-CHADS2scores displayed a greater incidence of MACE.

Keywords: Acute coronary syndrome; Mortality; Percutaneous coronary intervention; Risk assessment.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Artery Disease / mortality
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Non-ST Elevated Myocardial Infarction* / diagnosis
  • Non-ST Elevated Myocardial Infarction* / mortality
  • Percutaneous Coronary Intervention* / adverse effects
  • Predictive Value of Tests*
  • Prognosis
  • Prospective Studies
  • Registries*
  • Risk Assessment
  • Risk Factors
  • Time Factors