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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Circulation Society 2023
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.
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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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