Abstract
BACKGROUND: Acute coronary syndrome is the most common cause of cardiac morbidity and death. Various scoring systems have been developed in order to identify patients who are at risk for adverse outcome and may benefit from more aggressive and effective therapies. OBJECTIVES: This study was designed to evaluate the CHA(2)DS(2)VASC score as a predictor of mortality inpatients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention (p-PCI). METHODS: We evaluated 300 patients diagnosed with ST-elevation myocardial infarction who underwent p-PCI and calculated their CHA(2)DS(2)VASC scores. According to their CHA(2)DS(2)VASC scores, patients were divided into three groups. Group 1: 0-1 points (n = 101), Group 2: 2-3 points (n = 129), and Group 3: 4-9 points (n = 70). The mean, median and minimum duration of follow-up were 21.7 ± 9.4, 21, and 12 months, respectively. All-cause mortality was defined as the primary endpoint of the study. RESULTS: All-cause mortality was 4% in Group 1, 8.5% in Group 2 and 27.1% in Group 3 respectively. Kaplan-Meier analysis showed that Group 3 (CHA(2)DS(2)VASC ≥ 4) had a significantly higher incidence of death [p (log-rank) < 0.001]. In ROC analysis, AUC values for in hospital, 12-month and long-term mortality were 0.88 (0.77-0.99 95% CI), 0.82 (0.73-0.92 95% CI) and 0.79 (0.69-0.88 95% CI), respectively. CONCLUSIONS: CHA(2)DS(2)VASC score can be used for predicting both in-hospital, 12-month and long-term mortality in patients with STEMI who have undergone p-PCI.