Association of the CHA2DS2VASc Score with Acute Stent Thrombosis in Patients with an ST Elevation Myocardial Infarction Who Underwent a Primary Percutaneous Coronary Intervention

Objective: In this study, we aimed to determine the predictive value of the CHA(2)DS(2)VASc score for acute stent thrombosis in patients with an ST elevation myocardial infarction treated with a primary percutaneous coronary intervention (pPCI). Methods: This was a retrospective study conducted among 3,460 consecutive patients with STEMI who under-went a pPCI. The stent thrombosis was considered a definite or confirmed event in the presence of symptoms suggestive of acute coronary syndrome and angiographic confirmation of stent thrombosis based on the diagnostic guidelines of the Academic Research Consortium. The stent thrombosis was classified as acute if it developed within 24 h. Results: The mean CHA(2)DS(2)VASc score was 3.29 +/- 1.73 in the stent thrombosis group, whereas it was 2.06 +/- 1.14 in the control group (p < 0.001). In multivariable logistic regression analysis, CHA(2)DS(2)VASc scores >= 4 were independently associated with acute stent thrombosis (OR = 1.64; 95% CI 1.54-1.71, p < 0.001). In a receiver operating characteristic curve analysis, the best cut-off value for the CHA(2)DS(2)VASc score was >= 4, with 60% sensitivity and 73% specificity. Of note, patients with a CHA(2)DS(2)VASc score of 4 had a 4.3 times higher risk of acute stent thrombosis compared to those with a CHA(2)DS(2)VASc score of 1. Conclusions: The CHA(2)DS(2)VASc score may be a significant independent predictor of acute stent thrombosis in patients with STEMI treated with a pPCI. Therefore, the CHA(2)DS(2)VASc score may be used to assess the risk of acute stent thrombosis in patients with STEMI following a pPCI. (C) 2018 The Author(s) Published by S. Karger AG, Basel