Investigation of the relationship between CHA2DS2-VASc score and coronary complexity in atherosclerotic coronary artery disease.

Abstract

Aim:The CHA2DS2-VASc score is a clinical predictor of the risk of stroke in patients with atrial fibrillation. In this study, we aimed to investigate the relationship between CHA2DS2-VASc score and SYNTAX score (SS) in patients who were diagnosed as stable angina pectoris (SAP) and acute coronary syndrome (ACS). Methods and resuts:Total 488 patients who were diagnosed as SAP and ACS between January 2014 and February 2015 were enrolled. Coronary angiography was performed and SS was calculated. The risk factors of CAD and demographic features were recorded and CHA2DS2-VASc scores were calculated. Subsequently,statistical analysis was performed between the scores. The relationship between SS and age,hypertension, DM, EF and CHA2DS2-VASc score was investigated with nonparametric correlation tests. Positive correlation was determined between age and SS (r=,154,p<0,001). A positive correlation between SS and hypertension was statistically shown (r=,387,p<0,001). A positive correlation between the SS and presence DM (r=,220,p<0,001) was proved. A negative correlation was found between EF and SS (r=-,429,p<0,001). The relationship between CHA2DS2-VASc score and SS, which is the main purpose of the study was found to have a positive correlation (r=,379,p<0,001). The differences of median score between SAP and ACS groups were shown to be statistically significant (p<0,001).Likewise, the average score of SS between groups was found to be statistically significant (p<0,001). Conclusion:The relationship between CHA2DS2-VASc score and SS is shown in the spectrum of CAD including SAP and ACS. It has been demonstrated that the CHA2DS2-VASc score is a cheap, simple, practical and fast algorithm that correlates with coronary complexity.

Keywords

• CHA2DS2-VASc score
• SYNTAX score
• stable angina pectoris
• acute coronary syndrome
• coronary lesion complexity.

Aterosklerotik koroner arter hastalığında CHA2DS2-VASc skoruyla koroner kompleksitenin ilişkisinin araştırılması

Öz

Amaç: Atriyal fibrilasyonda tromboembolik inme risk tayininde kullanılan ve aterosklerotik koroner arter hastalığı (KAH) major risk faktörlerinin birçoğunu içeren CHA2DS2-VASc skorunun, koroner kompleksitenin ciddiyetini ve seviyesini belirlemede önemli veriler sunan SYNTAX skoru (SS) ile olan ilişkisini araştırmak. Gereç ve yöntemler: Çalışmamıza Ocak 2014 –Şubat 2015 tarihleri arasında akut koroner sendrom (AKS) ve stabil angina pektoris (SAP) tanılarıyla koroner anjiografileri yapılan 488 hasta alındı, SS hesaplandı. KAH için risk faktörleri, demografik özellikleri kayıt edildi ve CHA2DS2-VASc skorları hesaplandı. Sonrasında SAP ve AKS hastaları için belirtilen skorlar arasında istatiksel analizler yapıldı. Bulgular: SAP ve AKS tanılı tüm hastalarda SS ile yaş, hipertansiyon, diyabetes mellitus (DM), ejeksiyon fraksiyonu (EF) ve CHA2DS2-VASc skoru arasındaki ilişki nonparametrik korelasyon testleriyle araştırıldı. SS ile yaş arasında pozitif düzeyde korelasyon tespit edildi (r=,154, p<0,001). Hipertansiyon varlığı ile SS arasında pozitif yönde korelasyon olduğu istatiksel olarak gösterildi (r=,387, p<0,001). DM varlığı ile SS arasında da pozitif korelasyon olduğu görüldü (r=,220, p<0,001). EF ile SS arasında da negatif düzeyde korelasyon saptandı (r=-,429, p<0,001). Çalışmamızın temel noktası olan CHA2DS2-VASc skoru ile SS arasındaki ilişkinin de pozitif korelasyon şeklinde olduğu saptandı (r=,379, p<0,001). SAP ile AKS grupları arasında CHA2DS2-VASc skorunun ortanca değerinin farklılığının istatiksel olarak anlamlı olduğu gösterildi (p<0,001). Yine gruplar arasında SS ortalamasının istatiksel olarak anlamlı derecede farklı olduğu görüldü (p<0,001) Sonuç: SAP ve AKS'yi içeren KAH spektrumunda CHA2DS2-VASc skorunun SS ile ilişkisini gösterilmiştir. CHA2DS2-VASc skorunun koroner kompleksiteyle korelasyon gösteren, ucuz, basit, pratik ve hızlı bir algoritma olduğu ortaya konulmuştur.

Anahtar Kelimeler

• CHA2DS2-VASc skoru
• SYNTAX skoru
• stabil angina pektoris
• akut koroner sendrom
• koroner lezyon kompleksitesi

Kaynakça

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