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Several scoring systems have been developed to predict the prognosis of patients with an acute coronary syndomes. CHAD2DS2VASc Score was designed to estimate thromboembolic events in atrial fibrilation, nevertheless the components of this score include known coronary risk factors.The aim of this is study to analyse the the long-term predictive value in all-cause mortality of the CHAD2DS2Vasc score in STEMI patients undergoing primary PCI compared with the GRACE score.
From January 2008 to December 2015, 1499 consecutive patients with STEMI diagnosis who underwent primary-PCI were included. 3 groups of patients were made according to the score puntuation at admission as low risk 0 points(LR); intememediate risk 1-2(IR), and high risk as score ≥3(HR). The primary endpoit was all-cause mortality.
Mean age was 63,9±13,5, 77% of patients were male. 24,4% of patients were classified as LR patients, 44,1% as IR and 31,5 % as HR. Median follow-up was 2,78 years. All cause mortality was significantly lower in patients with LR and IR, when compared to those with HR (1.6% vs. 5.0% vs. 12.7%, p<0.001).(figure 1a) CHAD2DS2VASc was is an independent predictor of long-term all-cause mortality in a multivariate analysis (HR 1.32, CI95% 1.18-1.47, p< 0,00). The area under de curve for CHAD2DS2VASc score and GRACE RS were 0,719 and 0,701, (P=0,02 for both). No significative accuracity diferences for all-cause mortality were seen between CHADS2DS2Vasc score and GRACE score (Pairwise comparision of ROC curves by DeLong method z test = 0,821, p=0,417)
CHAD2VASC2 score was an independent predictor of long term all-cause mortality in our population of STEMI patients who underwent to primary PCI and may be a useful predictor of long term all-cause mortality.
CORONARY: Acute Myocardial Infarction