Value of CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF scores in predicting coronary artery lesion severity

LI Zhitong; ZHAO Mei

doi:10.3969/j.issn.1002-266X.2019.04.002

Abstract：Objective To explore the value of CHADS2, CHA2 DS2-VASc, and CHA2 DS2-VASc-HSF scores for prediction of coronary artery lesion severity. Methods Totally 542 coronary heart disease patients who underwent coronary angiography were selected. According to the clinical data, CHADS2, CHA2 DS2-VASc, and CHA2 DS2-VASc-HSF scores were calculated. SYNTAX score was calculated based on the results of CAG. Patients were divided into 2 groups: the mild& moderate lesion group (n = 506) and severe lesion group (n = 36) according to SYNTAX score. The biochemical indexes of the patients in the two groups were measured and compared to identify the risk factors of coronary artery lesion severity by using binary Logistic regression. Furthermore, AUC was calculated to access the predictive ability of three kinds of scores by using ROC curve. Methods Type 2 diabetes mellitus (OR = 3. 401, 95％ CI 1. 214-9. 527, P = 0. 020) and CHA2 DS2-VASc-HSF score (OR = 2. 100, 95％ CI 1. 163-3. 792, P = 0. 014) were the independent risk factors for coronary artery lesion severity. The CHADS2, CHA2 DS2-VASc, and CHA2 DS2-VASc-HSF scores were positively correlated with the coronary artery lesion severity (r = 0. 111, 0. 218, 0. 232 respectively; P = 0. 009, 0. 000, 0. 000, respectively).For prediction of severe coronary artery lesion, the AUC of CHADS2, CHA2 DS2-VASc and CHA2 DS2-VASc-HSF score was0. 715, 0. 732, and 0. 781, the optimal cut-off value of CHA2 DS2-VASc-HSF score was 4. 50 with a sensitivity of 80. 6％and a specificity of 63. 0％ (AUC: 0. 781, 95％ CI: 0. 721-0. 842, P = 0. 000). Conclusions Type 2 diabetes mellitus and CHA2 DS2-VASc-HSF score are the independent risk factors for the coronary artery lesion severity. Three kinds of scores are positively correlated with SYNTAX score. CHADS2, CHA2 DS2-VASc and CHA2 DS2-VASc-HSF score can be used as the valuable indicators of severe coronary artery lesion, and the predictive value of CHA2 DS2-VASc-HSF score＞4. 5 is the largest.