AUTHOR=Wu Yaxin , Gao Yanxiang , Li Qing , Wu Chao , Xie Enmin , Tu Yimin , Guo Ziyu , Ye Zixiang , Li Peizhao , Li Yike , Yu Xiaozhai , Ren Jingyi , Zheng Jingang 

TITLE=Predictive Value of the CHA2DS2-VASc Score for Mortality in Hospitalized Acute Coronary Syndrome Patients With Chronic Kidney Disease

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.790193

DOI=10.3389/fcvm.2022.790193

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>Chronic kidney disease (CKD) patients have a high prevalence of coronary artery disease and a high risk of cardiovascular events. The present study assessed the value of the CHA<sub>2</sub>DS<sub>2</sub>-VASc score for predicting mortality among hospitalized acute coronary syndrome (ACS) patients with CKD.</p></sec><sec><title>Methods</title><p>This was a retrospective cohort study that included CKD patients who were hospitalized for ACS from January 2015 to May 2020. The CHA<sub>2</sub>DS<sub>2</sub>-VASc score for each eligible patient was determined. Patients were stratified into two groups according to CHA<sub>2</sub>DS<sub>2</sub>-VASc score: &lt;6 (low) and ≥6 (high). The primary endpoint was all-cause mortality.</p></sec><sec><title>Results</title><p>A total of 313 eligible patients were included in the study, with a mean CHA<sub>2</sub>DS<sub>2</sub>-VASC score of 4.55 ± 1.68. A total of 220 and 93 patients were assigned to the low and high CHA<sub>2</sub>DS<sub>2</sub>-VASc score groups, respectively. The most common reason for hospitalization was unstable angina (39.3%), followed by non-ST-elevation myocardial infarction (35.8%) and ST-elevation myocardial infarction (24.9%). A total of 67.7% of the patients (212/313) received coronary reperfusion therapy during hospitalization. The median follow-up time was 23.0 months (interquartile range: 12–38 months). A total of 94 patients (30.0%) died during follow-up. The high score group had a higher mortality rate than the low score group (46.2 vs. 23.2%, respectively; <italic>p</italic> &lt; 0.001). The cumulative incidence of all-cause death was higher in the high score group than in the low score group (Log-rank test, <italic>p</italic> &lt; 0.001). Multivariate Cox regression analysis indicated that CHA<sub>2</sub>DS<sub>2</sub>-VASc scores were positively associated with all-cause mortality (hazard ratio: 2.02, 95% confidence interval: 1.26–3.27, <italic>p</italic> &lt; 0.001).</p></sec><sec><title>Conclusion</title><p>The CHA<sub>2</sub>DS<sub>2</sub>-VASc score is an independent predictive factor for all-cause mortality in CKD patients who are hospitalized with ACS. This simple and practical scoring system may be useful for the early identification of patients with a high risk of death.</p></sec>