The CHA2DS2-VASC Score Predicts Mortality in Patients Undergoing Coronary Angiography

Nicholay Teodorovich; Gera Gandelman; Michael Jonas; Yakov Fabrikant; Michael Sraia Swissa; Sara Shimoni; Jacob George; Moshe Swissa

doi:10.3390/life13102026

The CHA₂DS₂-VAS_C Score Predicts Mortality in Patients Undergoing Coronary Angiography

Life (Basel). 2023 Oct 9;13(10):2026. doi: 10.3390/life13102026.

Authors

Nicholay Teodorovich¹, Gera Gandelman¹, Michael Jonas¹, Yakov Fabrikant¹, Michael Sraia Swissa², Sara Shimoni¹, Jacob George¹, Moshe Swissa¹

Affiliations

¹ Kaplan Medical Center, Rehovot and the Hebrew University, Jerusalem 7661041, Israel.
² Shari-Zedek Medical Center, and the Hebrew University, Jerusalem 9103102, Israel.

Abstract

Background: The CHA₂DS₂-VAS_C score is used to predict the risk of thromboembolic complications in patients with atrial fibrillation (AF). We hypothesized that the CHA₂DS₂-VAS_C score can be used to predict mortality in patients undergoing coronary angiography.

Methods and results: This was a prospective study of 990 patients undergoing coronary angiography. The median follow-up was 2294 days. The patients were categorized into two groups according to their CHA₂DS₂-VAS_C score: group I had scores <4 and group II had scores ≥4 (527 (53.2%) and 463 (46.8%), respectively). A Kaplan-Meier analysis demonstrated a significant association between the CHA₂DS₂-VAS_C score and mortality (69/527 (13.1%) vs. 179/463 (38.7%) for group I vs. group II, respectively, p < 0.0001). The association remained significant in patients with and without AF, reduced and preserved LVEF, normal and reduced kidney function, and with and without ACS (p < 0.009 to p < 0.0001 for all). In the Cox regression model, which combined the CHA₂DS₂-VAS_C score, the presence of AF, LVEF, anemia, and renal insufficiency, an elevated CHA₂DS₂-VAS_C score of ≥4 was independently associated with higher mortality (HR 2.12, CI 1.29-3.25, p = 0.001).

Conclusions: The CHA₂DS₂VAS_C score is a simple and reliable mortality predictor in patients undergoing coronary angiography and should be used for the initial screening for such patients.

Keywords: CHA2DS2-VASC score; coronary angiography; mortality; outcomes.

Grants and funding

This research received no external funding.