Majalah Kardiologi Indonesia (Oct 2023)

Usefulness of The CHADS2 and CHA2DS2-VASc Scores in Predicting In-Hospital Mortality in Acute Coronary Syndrome Patients: A Single-Center Retrospective Cohort Study

  • Miftah Pramudyo,
  • Iwan Cahyo Santosa Putra, M.D.,
  • Fahmi Bagus Pratama, M.D.,
  • Raymond Pranata, M.D.

DOI
https://doi.org/10.30701/ijc.1294
Journal volume & issue
Vol. 44, no. 1

Abstract

Read online

Background Although the GRACE risk score is widely accepted as an established scoring system to predict in-hospital mortality in acute coronary syndrome (ACS) patients, this scoring system still depends on electrocardiography and laboratory findings to determine the results. Therefore, we aim to retrospectively evaluate the association between the CHADS2 and CHA2DS2-VASc score as an anamnesis-only mediated scoring system and in-hospital mortality in hospitalized ACS patients. Methods This retrospective cohort study analyzed data of ACS patients from the ACS registry in Dr. Hasan Sadikin Central General Hospital from 2018 to 2021. The outcome of this study was in-hospital mortality. The association between these scoring system and in-hospital mortality were evaluated using binary logistic regression analysis. Receiver operating characteristics (ROC) analysis was also performed to assess the success rate of this scoring system in predicting in-hospital mortality. Results A total of 1339 patients were included in this study, and 162 (12.1%) of them died in the hospital. High CHA2DS2-VASc score group (cut-off >2) was significantly associated with higher risk of in-hospital mortality before (OR=2.56 [1.75,3.75]; p2) was only significantly increased the risk of in-hospital mortality in univariate analysis (OR=2.05[1.47,2.87];p2 was significantly and independently associated with higher in-hospital mortality in ACS patients compared to the CHA2DS2-VASc score of 1 or lower. Despite its lower predictive accuracy compared to the GRACE risk score, CHA2DS2-VASc score can still be used in practical situations as an alternative scoring system in predicting in-hospital mortality in ACS patients, especially in primary health care settings located in rural areas that lack the diagnostic facilities.

Keywords