CHA2DS2-VASc score is useful in predicting poor 12-month outcomes following myocardial infarction in diabetic patients without atrial fibrillation.
Acta Diabetol
; 53(5): 807-15, 2016 Oct.
Article
em En
| MEDLINE
| ID: mdl-27339195
ABSTRACT
AIMS:
TIMI risk score and GRACE risk model are widely available and accepted scores for risk assessment in STEMI patients and include predictors of poor outcomes. CHA2DS2-VASc is a validated score for predicting embolic/stroke risk in patients with non-valvular atrial fibrillation. Its components contribute to the worse prognosis following myocardial infarction. The advantage of the CHA2DS2-VASc score in comparison with other risk scores is that it provides a comprehensive, fast, and simple method for physicians in risk evaluation that requires no calculators or computers. Therefore, we have set out to examine the prognostic significance of CHA2DS2-VASc score following STEMI in diabetic patients without AF.METHODS:
A total of 472 patients with diabetes mellitus and STEMI undergoing primary PCI were enrolled. Based on the estimated CHA2DS2-VASc score, the study population was divided into three groups group 1 (N = 111) with a moderate CHA2DS2-VASc score of 2 or 3; group 2 (N = 257) with a high CHA2DS2-VASc score of 4 or 5; and group 3 (N = 104) with a very high CHA2DS2-VASc score of 6 or higher.RESULTS:
In diabetic patients with STEMI, the median of CHA2DS2-VASc score was 4 (interquartile range 3-5). In-hospital mortality rate was similar across three groups. CHA2DS2-VASc score was not a risk factor of in-hospital mortality. ROC analysis revealed good diagnostic value of CHA2DS2-VASc score in predicting long-term mortality (AUC 0.62 95 % CI 0.57-0.66 P = 0.0003) and stroke (AUC 0.75 95 % CI 0.71-0.79 P = 0.0003), but no value in predicting long-term myocardial infarction. CHA2DS2-VASc score was an independent predictor of 12-month mortality and stroke. One-point increment in CHA2DS2-VASc score was associated with an increase in the risk of 12-month death by 24 % and for 12-month stroke by 101 %.CONCLUSIONS:
In diabetic patients with STEMI and no previous AF, median CHA2DS2-VASc score was high (4 points) and predicted 12-month death and stroke. However, it failed to predict in-hospital death and 12-month MI. CHA2DS2-VASc score had a similar discrimination performance in predicting 12-month mortality as TIMI risk score and a better discrimination performance in predicting 12-month stroke than TIMI risk score. Thus, it can serve as an additive tool in identifying high-risk patients that require aggressive management.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Diabetes Mellitus
/
Escores de Disfunção Orgânica
/
Infarto do Miocárdio
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Acta Diabetol
Assunto da revista:
ENDOCRINOLOGIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Polônia
País de publicação:
ALEMANHA
/
ALEMANIA
/
DE
/
DEUSTCHLAND
/
GERMANY