The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Predictive value of CHADS2 score for cardiovascular events in patients with acute coronary syndrome and documented coronary artery disease

  • Kang, In Sook (Department of Internal Medicine, Green Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine) ;
  • Pyun, Wook Bum (Division of Cardiology, Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Shin, Gil Ja (Division of Cardiology, Department of Internal Medicine, Ewha Womans University School of Medicine)
  • Received : 2014.07.12
  • Accepted : 2014.11.20
  • Published : 2016.01.01
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Abstract

Background/Aims: The $CHADS_2$ score, used to predict the risk of ischemic stroke in atrial fibrillation (AF) patients, has been reported recently to predict ischemic stroke in patients with coronary heart disease, regardless of the presence of AF. However, little data are available regarding the relationship between the $CHADS_2$ score and cardiovascular outcomes. Methods: This was a retrospective study on 104 patients admitted for acute coronary syndrome (ACS) who underwent coronary angiography, carotid ultrasound, and transthoracic echocardiography. Results: The mean age of the subjects was $60.1{\pm}12.6years$. The $CHADS_2$ score was as follows: 0 in 46 patients (44.2%), 1 in 31 (29.8%), 2 in 18 (17.3%), and ${\geq}3$ in 9 patients (8.7%). The left atrial volume index (LAVi) showed a positive correlation with the $CHADS_2$ score ($20.8{\pm}5.9$ for 0; $23.2{\pm}6.7$ for 1; $26.6{\pm}10.8$ for 2; and $30.3{\pm}8.3mL/m^2$ for ${\geq}3$; p = 0.001). The average carotid total plaque area was significantly increased with $CHADS_2$ scores ${\geq}2$($4.97{\pm}7.17mm^2$ vs. $15.52{\pm}14.61mm^2$; p = 0.002). Eight patients experienced cardiovascular or cerebrovascular (CCV) events during a mean evaluation period of 662 days. A $CHADS_2$ score ${\geq}3$ was related to an increase in the risk of CCV events (hazard ratio, 14.31; 95% confidence interval, 3.53 to 58.06). Furthermore, LAVi and the severity of coronary artery obstructive disease were also associated with an increased risk of CCV events. Conclusions: The $CHADS_2$ score may be a useful prognostic tool for predicting CCV events in ACS patients with documented coronary artery disease.

Keywords

References

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