Use of Modified CHA2DS2-VASC Score for Risk Prediction in Patients Undergoing PCI

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Abstract Background: Most of the existing risk prediction models include angiographic or procedural variables thus making it difficult for their application in decision making at the outset of treatment. This study we used modified CHA2DS2-VASC score as a simple tool for risk stratification of patients with PCI, regardless of atrial fibrillation (AF). Methods: This is a prospective observation study of patients who had undergone PCI, with diagnosis of either ACS or chronic stable angina between the age group of 18 to 85 years. Modified CHA2DS2-VASC score (CAD presence was not given one point) was calculated in the patients before PCI and followed for occurrence of MACCE or death. Score was correlated with primary outcome death or MACCE. Results: Total of 676 patients were considered for this study, Mean modified CHA2DS2-VASC score of the study population is 1.86± 1.26. Sub group analysis of the patients by dividing into groups with a score less than 1 and greater than 1 revealed that there is no statistical difference in either MACCE ( p = 0.31) or death (p=0.6) between the groups. Subgroup analysis of ≤1 and ≥5 modified CHA2DS2VASc score has no statistically significant difference in MACCE (p=0.45), but has statistically significant difference in death rate by Fischer exact test(p=0.02) and by chi-square Yates correction (p=0.01). Further analysis also shows that patients with score ≥5 had 13 times increased risk of death when compared with score ≤1. Conclusion: Modified CHA2DS2-VASc Score is a simple clinical tool for predicting outcome in patients planned for PCI. Risk of death clearly correlate with the score when score was more than 5 point.

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