Usefulness of the CHA2DS2-VASC Score to Predict Adverse Outcomes in Patients Having Percutaneous Coronary Intervention

Abstract

The application of the CHA2DS2-VASC score as a novel risk stratification tool for predicting outcome in clinical applications other than atrial fibrillation and stroke prevention has been previously examined. However, its usefulness in a population of patients with coronary artery disease after percutaneous coronary intervention (PCI) has not been explored. We investigated 12,785 consecutive patients who underwent PCI in a tertiary medical center from April 2004 to August 2014 (mean follow-up 6.5 years) and computed the CHA2DS2-VASC score on their index PCI. We assessed the relation between the CHA2DS2-VASC score and clinical outcomes (for example, all-cause mortality and mortality or myocardial infarction) at 1 and 5 years. The mean CHA2DS2-VASC score was 3.7 ± 1.7, 59.1% of patients obtained a score of 3 to 5. Both the primary and secondary outcomes at 1 and 5 years were significantly more frequent as the CHA2DS2-VASC score increased. Overall, the mortality rate after PCI was 10 times higher for patients with a CHA2DS2-VASC score of 5 compared with a score of 1 at both 1-and 5-year follow-up. The CHA2DS2-VASC score predicted all-cause mortality and death or nonfatal myocardial infarction in a significant (p <0.001, C-index 0.73 and 0.72) and linear fashion. In conclusion, the CHA2DS2-VASC score can be used as a simple and effective tool to predict long-term clinical outcomes in patients undergoing PCI.