CHA2DS2-VASC score predicts coronary artery disease progression and mortality after ventricular arrhythmia in patients with implantable cardioverter-defibrillator.
Int J Cardiol Heart Vasc
; 34: 100802, 2021 Jun.
Article
in En
| MEDLINE
| ID: mdl-34095451
ABSTRACT
AIM:
The CHA2DS2-VASC score has expanded its use beyond the initial purpose of predicting the risk of stroke in patients with atrial fibrillation. We aimed to investigate the value of the CHA2DS2-VASC score as a risk assessment tool to predict relevant coronary artery disease (CAD) leading to percutaneous coronary intervention (PCI), and all-cause mortality after detected ventricular arrhythmia (VA) in patients with an Implantable Cardioverter-Defibrillator (ICD).METHODS:
A total of 183 ICD-patients who underwent coronary angiography after VA were included and classified according to their CHA2DS2-VASC score in a low(1-3), intermediate(4-5) and high(6-8) score group. We evaluated the predictive value of CHA2DS2-VASC score for the presence of relevant CAD leading to percutaneous coronary intervention (PCI), as well as late all-cause mortality.RESULTS:
A total of 60 patients (32.8%) had significant CAD and underwent successful PCI. After adjustment for relevant parameters such as ischemic cardiomyopathy, angina pectoris, left ventricular ejection fraction, CHA2DS2-VASC score remained the only independent predictor of CAD leading to PCI [HR 1.73 (1.07-2.80)]. The Area under curve was 0.64 (0.56-72, p = 0.002). Kaplan-Meier analysis and log-rank showed an increased three-year mortality of ICD-patients with an intermediate or high score after VA (p = 0.003). Multivariate cox-regression analysis revealed that CHA2DS2-VASC score was also independently associated with all-cause mortality following adjustment for clinically relevant variables (HR 2.20, 1.17-4.14).CONCLUSIONS:
CHA2DS2-VASC score can be a predictor of CAD leading to PCI in ICD-patients after VA. ICD-Patients with a high score have an increased risk for reduced three-year all-cause mortality after VA.
AF, Atrial fibrillation; CABG, Coronary artery bypass graft; CAD, Coronary artery disease; CK-MB, Creatine Kinase MB Isoenzyme; Coronary angiography; Coronary artery disease; ICD, Implantable Cardioverter-Defibrillator; Implantable Cardioverter Defibrillator; LDL, Low-Density Lipoprotein; LVEF, Left Ventricular Ejection Fraction; PCI, Percutaneous Coronary Intervention; VA, Ventricular Arrhythmia; VF, Ventricular Fibrillation; VT, Ventricular Tachycardia; Ventricular fibrillation; Ventricular tachycardia
Full text:
1
Collection:
01-internacional
Health context:
6_ODS3_enfermedades_notrasmisibles
Database:
MEDLINE
Type of study:
Prognostic_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Language:
En
Journal:
Int J Cardiol Heart Vasc
Year:
2021
Document type:
Article