Importance and usage of the CHA2DS2-VASc score in predicting acute stent thrombosis

Objective The CHA(2)DS(2)-VASc score is used to estimate thromboembolic risk in atrial fibrillation (AF). Its usefulness in predicting outcome in patients after a percutaneous coronary intervention is unknown. We aimed to evaluate the predictive value of the CHA(2)DS(2)-VASc score in AF-free patients who have undergone stent implantation. Design Patients were evaluated retrospectively. Among the 1371 patients, 38 presented with acute stent thrombosis (ST) and were included in the study. The CHA(2)DS(2)-VASc score was calculated before percutaneous coronary intervention and the association between the score and stent thrombosis was investigated. Results The patients were grouped into ST (+) and ST (-). The average CHA(2)DS(2)-VASc score for the ST (+) group was 3.79, whereas that for the ST (-) group was 2.16 (P<0.001). A direct correlation was observed between CHA(2)DS(2)-VASc scores and the rate of ST. When patients with a CHA(2)DS(2)-VASc score of greater than 2 were compared with those with a CHA(2)DS(2)-VASc score of up to 2, the higher score had a higher frequency of ST (P<0.001) and multivariate analysis identified the CHA(2)DS(2)-VASc score as an independent predictor of acute ST. Conclusion A CHA(2)DS(2)-VASc score of greater than 2 was found to be an independent predictor for incidence of ST. The role of the CHA(2)DS(2)-VASc score in predicting ST has not been investigated earlier in an AF-free population and our study is the first to explore this aspect. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.