The CHA2DS2-VASc Score as an Early Predictor of Graft Failure After Coronary Artery Bypass Surgery

Background and objective Graft patency is one of the major concerns after coronary artery bypass graft (CABG) surgery. The CHA(2)DS(2)-VASc [congestive heart failure, hypertension, age >= 75 years, diabetes mellitus (DM), stroke or transient ischemic attack (TIA), vascular disease, age 65 to 74 years, sex category] score is a tool that was developed to predict the risk of thrombotic events in patients with atrial fibrillation (AF). In this study, we evaluated the use of the CHA(2)DS(2)-VASc score as a simple tool for predicting graft failure (GF) among patients who underwent CABG surgery. Methods In this retrospective case-control study, a total of 280 patients were enrolled after applying the exclusion criteria. Angiograms were analyzed by using the QCA software system (Pie Medical Imaging, Maastricht, The Netherlands) for each patient. A graft was described as failed if it had 70% or more stenosis or was completely occluded. Patients were classified into two groups: group one included patients without GF (GF-N) and group two included patients with GF (GF-Y). Thereafter, the CHA(2)DS(2)-VASc risk score was calculated for each patient. Results In our cohort, 136 patients had GF (GF-Y group) and 144 patients did not have GF (GF-N group). GF-N and GF-Y patients had their angiography performed 100.31 +/- 8.04 and 103.49 +/- 8.41 months after CABG, respectively. GF-Y group had a significantly higher rate of DM, hypertension, and heart failure with reduced ejection fraction (HFrEF). GF-Y group had higher CHA(2)DS(2) (GF-N group: 1.47 +/- 0.91 vs. GF-Y group: 2.57 +/- 1.17, p=0.0001) and CHA(2)DS(2)-VASc score (GF-N group: 2.80 +/- 1.11 vs. GE-Y group: 4.15 +/- 1.25, p=0.0001). Analyses showed that only CHA(2)DS(2)-VASc was an independent predictor of GF while other parameters including DM, hypertension, HFrEF, creatinine, and CHADS(2) were not found to be independent predictors of GE. A CHA(2)DS(2)-VASc score of >3 predicted GF with a sensitivity of 65.44% and a specificity of 74.31%. Conclusions The CHA(2)DS(2)-VASc score might be used as a feasible and simple method to predict the risk of GF after CABG surgery.