Abstract

The CHA2DS2-VASc is well-validated stroke risk prediction scores for atrial fibrillation (AF), but its role in risk stratification of major adverse cardiac events (MACEs) for non-AF patients undergoing percutaneous coronary intervention (PCI) is unknown. Aims and Objectives: Primary endpoint of the study was risk assessment by CHA2DS2-VASc Score to predict the prognosis in patients with acute coronary syndrome undergoing PCI and comparison of CHA2DS2-VASc score with GRACE and TIMI risk score. The secondary endpoint of the study was short-term in-hospital mortality of all cause. Methods: 350 patients without AF undergoing PCI were analysed in the Department of Cardiology, S.M.S medical college and attached group of hospitals, Jaipur. A composite of MACE including cardiovascular death, nonfatal MI, or stroke was defined as the primary study endpoint. Cardiovascular death was defined as death attributed to MI, congestive heart failure, or documented sudden cardiac death. Results: MACE in hospital was present in 21 (6%) and Ischaemic stroke in 10 (2.6%). Myocardial infarction in 5 (1.4%) and death was reported in 12 (3.4%) of the participants. A significant relation was observed in MACE, Ischaemic stroke and death with categories of CHA2-DS2-VASc score. In patients without AF undergoing PCI we showed that the CHA2DS2-VASc score was comparable to the GRACE score which recommended by guideline which require ECG and cardiac enzyme information for prediction in-hospital mace. In our study the CHA2DS2-VASc score performed significantly better than TIMI-NSTEMI/UAP, TIMI-STEMI which requires angiographic information for prediction of in- hospital MACE. Conclusion: These findings shall give clinicians confidence to use the CHA2DS2-VASc score for risk prediction and provide an opportunity for an early risk stratification before ECG, enzyme and angiographic information become available.

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