The predictive value of the CHA 2DS 2-VASc score for in-hospital outcomes in patients with acute myocardial infarction: China PEACE-retrospective acute myocardial infarction study
10.3760/cma.j.cn112138-20210913-00634
- VernacularTitle:CHA 2DS 2-VASc评分对急性心肌梗死患者院内结局事件的预测价值——China PEACE回顾性急性心肌梗死研究
- Author:
Ping QING
1
;
Yanmin YANG
;
Shuang HU
;
Litian YU
;
Wei XU
;
Lulu WANG
;
Ni SUO
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院心内重症监护病房，北京100037
- Keywords:
Myocardial infarction;
Hospital mortality;
CHA 2DS 2-VASc score;
Death or treatment withdrawal risk;
Risk assessment
- From:
Chinese Journal of Internal Medicine
2022;61(2):177-184
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:This study aimed to evaluate the predictive value of the CHA 2DS 2-VASc score for in-hospital outcomes of patients with acute myocardial infarction (AMI). Methods:Data of 23 728 patients from the China patient-centered Evaluative Assessment of cardiac Events (China PEACE)Retrospective Acute Myocardial Infarction Study were analyzed retrospectively. The patients were categorized into 3 groups according to the CHA 2DS 2-VASc scores: the low score group (score 1-3), the middle score group (score 4-6) and the high score group (score 7-9). The in-hospital outcomes included major adverse cardiovascular events (MACE), death, death or withdrawal from treatment, reinfarction, ischemic stroke,etc. The CHA 2DS 2-VASc score was incorporated into multivariate Cox regression analyses to determine its independent impact on in-hospital outcomes. Receiver operating Characteristic (ROC) curves were constructed, and the area under the curve (AUC) was used to evaluate the predictive value of the CHA 2DS 2-VASc score for in-hospital mortality and death or withdrawal from treatment, respectively. Results:The patients had a median age of 66 (56,75) years, and 30.7% of them were females. Patients with higher CHA 2DS 2-VASc scores had a higher in-hospital mortality and more in-hospital complications (all P<0.001). After adjustment of baseline covariates, the subjects in the high score group were associated with high risks of in-hospital mortality ( OR=6.13, 95% CI 4.77-7.87, P<0.001), death or treatment withdrawal ( OR=6.43, 95% CI 5.16-8.00, P<0.001) and MACE ( OR=4.94, 95% CI 4.06-6.01, P<0.001). The AUCs of the CHA 2DS 2-VASc score were comparable with those of the mini-global registry of acute coronary events(mini-GRACE)score in evaluation of in-hospital mortality (0.699 vs. 0.696, P=0.752) and the death or treatment withdrawal risk (0.708 vs. 0.713, P=0.489). Conclusions:The CHA 2DS 2-VASc score is an independent predictor of in-hospital outcomes for patients with AMI. Its predictive value was comparable with the mini-GRACE score, which could be used as a simple tool for early and rapid outcome evaluation for AMI patients.
