• Sao Paulo Med J · Jul 2019

    Observational Study

    The CHA2DS2-VASc score for predicting atrial fibrillation in patients presenting with ST elevation myocardial infarction: prospective observational study.

    • Fatih Aksoy, Hasan Aydin Baş, Ali Bağcı, and Tulay Oskay.
    • MD. Associate Professor, Department of Cardiology, Süleyman Demirel Üniversitesi Tıp Fakültesi, Isparta, Turkey.
    • Sao Paulo Med J. 2019 Jul 22; 137 (3): 248254248-254.

    BackgroundAtrial fibrillation (AF) is the most common form of supraventricular arrhythmia following ST-elevation myocardial infarction (STEMI). The CHA2DS2-VASc and CHADS2 scores are used to estimate thromboembolic risk in cases of AF. Their usefulness in predicting the development of AF in patients presenting STEMI is unknown.ObjectiveTo evaluate the predictive value of the CHADS2 and CHA2DS2-VASc scores in patients with AF following STEMI.Design And SettingThis prospective cohort study on 696 patients with STEMI was conducted at a tertiary-level cardiology clinic in a public university hospital.MethodsModels including clinical and laboratory parameters were constructed to test the predictive value of CHADS2 and CHA2DS2-VASc scores. Patients were divided into two groups: with and without AF. Predictors of AF were determined using multivariate regression analysis.ResultsIn the patients with AF, CHADS2 and CHA2DS2-VASc scores were significantly higher than in those without AF (for both P < 0.001). Factors associated with AF in multivariate analyses included CHA2DS2-VASc score (odds ratio, OR: 1.48; 95% confidence interval, CI: 1.25-1.75; P < 0.001), peak creatine kinase-myocardial binding (OR: 1.002; 95% CI: 1.00-1.003; P = 0.0024), duration of the coronary intensive care unit stay (OR: 1.69; 95% CI: 1.24-12.30; P = 0.001) and no use of renin-angiotensin system blockers (OR: 2.16; 95% CI: 1.14-4.10; P = 0.0017). Receiver operating characteristic curve analyses showed that CHA2DS2-VASc scores were significant predictors for new-onset AF (C-statistic: 0.698; 95% CI: 0.631-0.765; P < 0.001).ConclusionCHADS2 and CHA2DS2-VASc scores predicted new AF in patients presenting STEMI.

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