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Prognostic Impacts of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS Scores on Clinical Outcomes After Elective Drug-Eluting Stent Placement for De Novo Coronary Stenosis
Background: The prognostic impact of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS scores on clinical outcomes after drug-eluting stent (DES) placement has not been fully elucidated. Methods and Results: The present study was a retrospective, non-randomized, single-center, and lesion-based stu...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Circulation Society
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072895/ https://www.ncbi.nlm.nih.gov/pubmed/37025938 http://dx.doi.org/10.1253/circrep.CR-22-0120 |
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author | Ukaji, Tomoaki Ishikawa, Tetsuya Nakamura, Hidehiko Mizutani, Yukiko Yamada, Kouta Shimura, Masatoshi Kondo, Yuki Tamura, Yohei Koshikawa, Yuri Hisauchi, Itaru Nakahara, Shiro Itabashi, Yuji Kobayashi, Sayuki Taguchi, Isao |
author_facet | Ukaji, Tomoaki Ishikawa, Tetsuya Nakamura, Hidehiko Mizutani, Yukiko Yamada, Kouta Shimura, Masatoshi Kondo, Yuki Tamura, Yohei Koshikawa, Yuri Hisauchi, Itaru Nakahara, Shiro Itabashi, Yuji Kobayashi, Sayuki Taguchi, Isao |
author_sort | Ukaji, Tomoaki |
collection | PubMed |
description | Background: The prognostic impact of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS scores on clinical outcomes after drug-eluting stent (DES) placement has not been fully elucidated. Methods and Results: The present study was a retrospective, non-randomized, single-center, and lesion-based study. Target lesion failure (TLF), comprising cardiac death, non-fatal myocardial infarction, and target vessel revascularization, occurred in 7.1% of 872 consecutive de novo coronary lesions in 586 patients. These patients were electively and exclusively treated by DESs from January 2016 to January 2022 until July 2022 with a mean (±SD) observational interval of 411±438 days. Multivariate Cox proportional hazard analysis revealed that CHA(2)DS(2)-VASc-HS scores ≥7 (hazard ratio [HR] 1.800; 95% CI 1.06–3.05; P=0.029) was a significant predictor of cumulative TLF among 24 variables evaluated. CHADS(2) scores ≥2 (HR 3.213; 95% CI 1.32–7.80; P=0.010) and CHA(2)DS(2)-VASc scores ≥5 (HR 1.980; 95% CI 1.10–3.55; P=0.022) were also significant in the multivariate analysis. Pairwise comparisons of receiver operating characteristic curves for CHADS(2) score ≥2, CHA(2)DS(2)-VASc score ≥5, and CHA(2)DS(2)-VASc-HS score ≥7 showed they were equivalent in terms of predicting the incidence of TLF, with areas under the curve of 0.568, 0.575, and 0.573, respectively. Conclusions: All 3 cardiocerebrovascular thromboembolism risk scores were strong predictors of the incidence of cumulative mid-term TLF after elective DES placement, with cut-off values of 2, 5, and 7, respectively, and equivalent prognostic impacts. |
format | Online Article Text |
id | pubmed-10072895 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Japanese Circulation Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-100728952023-04-05 Prognostic Impacts of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS Scores on Clinical Outcomes After Elective Drug-Eluting Stent Placement for De Novo Coronary Stenosis Ukaji, Tomoaki Ishikawa, Tetsuya Nakamura, Hidehiko Mizutani, Yukiko Yamada, Kouta Shimura, Masatoshi Kondo, Yuki Tamura, Yohei Koshikawa, Yuri Hisauchi, Itaru Nakahara, Shiro Itabashi, Yuji Kobayashi, Sayuki Taguchi, Isao Circ Rep Original article Background: The prognostic impact of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS scores on clinical outcomes after drug-eluting stent (DES) placement has not been fully elucidated. Methods and Results: The present study was a retrospective, non-randomized, single-center, and lesion-based study. Target lesion failure (TLF), comprising cardiac death, non-fatal myocardial infarction, and target vessel revascularization, occurred in 7.1% of 872 consecutive de novo coronary lesions in 586 patients. These patients were electively and exclusively treated by DESs from January 2016 to January 2022 until July 2022 with a mean (±SD) observational interval of 411±438 days. Multivariate Cox proportional hazard analysis revealed that CHA(2)DS(2)-VASc-HS scores ≥7 (hazard ratio [HR] 1.800; 95% CI 1.06–3.05; P=0.029) was a significant predictor of cumulative TLF among 24 variables evaluated. CHADS(2) scores ≥2 (HR 3.213; 95% CI 1.32–7.80; P=0.010) and CHA(2)DS(2)-VASc scores ≥5 (HR 1.980; 95% CI 1.10–3.55; P=0.022) were also significant in the multivariate analysis. Pairwise comparisons of receiver operating characteristic curves for CHADS(2) score ≥2, CHA(2)DS(2)-VASc score ≥5, and CHA(2)DS(2)-VASc-HS score ≥7 showed they were equivalent in terms of predicting the incidence of TLF, with areas under the curve of 0.568, 0.575, and 0.573, respectively. Conclusions: All 3 cardiocerebrovascular thromboembolism risk scores were strong predictors of the incidence of cumulative mid-term TLF after elective DES placement, with cut-off values of 2, 5, and 7, respectively, and equivalent prognostic impacts. The Japanese Circulation Society 2023-03-15 /pmc/articles/PMC10072895/ /pubmed/37025938 http://dx.doi.org/10.1253/circrep.CR-22-0120 Text en Copyright © 2023, THE JAPANESE CIRCULATION SOCIETY https://creativecommons.org/licenses/by-nc-nd/4.0/This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license. |
spellingShingle | Original article Ukaji, Tomoaki Ishikawa, Tetsuya Nakamura, Hidehiko Mizutani, Yukiko Yamada, Kouta Shimura, Masatoshi Kondo, Yuki Tamura, Yohei Koshikawa, Yuri Hisauchi, Itaru Nakahara, Shiro Itabashi, Yuji Kobayashi, Sayuki Taguchi, Isao Prognostic Impacts of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS Scores on Clinical Outcomes After Elective Drug-Eluting Stent Placement for De Novo Coronary Stenosis |
title | Prognostic Impacts of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS Scores on Clinical Outcomes After Elective Drug-Eluting Stent Placement for De Novo Coronary Stenosis |
title_full | Prognostic Impacts of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS Scores on Clinical Outcomes After Elective Drug-Eluting Stent Placement for De Novo Coronary Stenosis |
title_fullStr | Prognostic Impacts of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS Scores on Clinical Outcomes After Elective Drug-Eluting Stent Placement for De Novo Coronary Stenosis |
title_full_unstemmed | Prognostic Impacts of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS Scores on Clinical Outcomes After Elective Drug-Eluting Stent Placement for De Novo Coronary Stenosis |
title_short | Prognostic Impacts of CHADS(2), CHA(2)DS(2)-VASc, and CHA(2)DS(2)-VASc-HS Scores on Clinical Outcomes After Elective Drug-Eluting Stent Placement for De Novo Coronary Stenosis |
title_sort | prognostic impacts of chads(2), cha(2)ds(2)-vasc, and cha(2)ds(2)-vasc-hs scores on clinical outcomes after elective drug-eluting stent placement for de novo coronary stenosis |
topic | Original article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072895/ https://www.ncbi.nlm.nih.gov/pubmed/37025938 http://dx.doi.org/10.1253/circrep.CR-22-0120 |
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