The Predictive Role of the CHADS-VASc Score on Reduced Left Ventricular Ejection Fraction in Patients with Acute Coronary Syndrome

CHA2DS2-VASc score in acute coronary syndrome


  • Uğur Küçük Çanakkale Onsekiz Mart University Medical Faculty, Department of Cardiology, Çanakkale, Turkey


CHA2DS2-VASc score, ejection fraction, acute coronary syndrome


Background: Reduced left ventricular systolic function is associated with significant mortality and morbidity in patients with the acute coronary syndrome (ACS). Predicting which patients may go on to develop heart failure (HF) with optimal treatment is thus likely to be effective in reducing mortality and morbidity. This study aims to evaluate the role of the CHA2DS2-VASc score in predicting reduced left ventricular ejection fraction (LVEF) in patients with ACS.
Methods: 202 patients diagnosed with the ACS participated in the study. Coronary angiography (CAG) was performed on all patients. The LVEF values of the patients before and three months after discharge were evaluated by transthoracic echocardiogram (TTE). Group 1 consisted of patients with LVEF values below 50% at the third month, while Group 2 consisted of those with LVEF values of 50% and above.
Results: The mean age of the patients was 62 ± 12 years, and 142 of the patients were male. The LVEF values in the third month were 55.58 ± 0.24 in Group 1 and 42.07 ± 0.86 in Group 2 (p<0.001). While the mean CHA2DS2-VASc score was 0.86 ± 0.78 in Group 1, it was 1.78 ± 0.87 in Group 2 (p<0.001). Multiple regression analysis showed that the CHA2DS2-VASc score had an independent relationship in predicting the LVEF values in patients with ACS (Odds ratio [OR] 3.179, 95% CI 1.972-5.124, p<0.001). CHA2DS2- VASc scores above 1.5 can be used as a predictor for decreased left ventricular systolic function in patients with ACS with 53% sensitivity and 80% specificity.
Conclusion: The CHA2DS2-VASc score is a simple and easy parameter that can be used to predict decreased and preserved left ventricular systolic functions in patients with ACS.