Background

The rate of saphenous vein graft (SVG) occlusion within the first year of bypass graft surgery is 15%. The CHA₂DS₂-VASc score is used to predict the risk of thromboembolic events in patients with nonvalvular atrial fibrillation. We aimed to evaluate the predictive role of the CHA₂DS₂-VASc score in the estimation of intracoronary thrombus burden in patients with acute myocardial infarction (AMI) who underwent SVG-PCI.

Methods

We retrospectively evaluated 221 patients who were admitted with AMI and underwent PCI of SVGs at the Department of Cardiology in the Turkiye Yuksek Ihtisas Education and Research Hospital between 2012 and 2018. The study population was divided into two groups according to their Thrombolysis in Myocardial Infarction (TIMI) thrombus grade: low thrombus burden (LTB; TIMI 0–3) and high thrombus burden (HTB; TIMI 4 and 5).

Results

The study included 221 patients with a mean age of 63.3 ± 6.7 years. The patients with HTB had significantly higher CHA₂DS₂-VASc scores (p < 0.001) compared with LTB patients. Univariate and multivariate regression analysis demonstrated that both CHA₂DS₂-VASc score (OR: 1.573, 95% CI: 1.153–2.147, p = 0.004) as a continuous variable and a binary cut-off level of the CHA₂DS₂-VASc score > 3 (OR: 3.876, 95% CI: 1.705–8.808, p = 0.001) were significantly associated with HTB. The ability of the CHA₂DS₂-VASc score to predict HTB burden was evaluated by receiver-operating characteristics analysis curve analysis. The optimum cut-off value of the CHA₂DS₂-VASc score for predicting HTB was 3 (with a sensitivity of 67.9% and a specificity of 69.3%) according to the Youden index.

Conclusion

The CHA₂DS₂-VASc score can be used as an easy practical tool to predict HTB in AMI patients undergoing SVG-PCI.

中文翻译：

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接受 SVG-PCI 的急性心肌梗死患者 CHA2DS2-VASc 评分与血栓负荷的关系

背景

旁路移植手术第一年内大隐静脉移植 (SVG) 闭塞率为 15%。CHA ₂ DS ₂ -VASc 评分用于预测非瓣膜性心房颤动患者血栓栓塞事件的风险。我们旨在评估 CHA ₂ DS ₂ -VASc 评分在估计接受 SVG-PCI 的急性心肌梗死 (AMI) 患者冠状动脉内血栓负荷中的预测作用。

方法

我们回顾性评估了 2012 年至 2018 年期间在 Turkiye Yuksek Ihtisas 教育和研究医院心脏病科接受 AMI 并接受 SVGs PCI 的 221 名患者。研究人群根据他们在心肌梗死中的溶栓分为两组（ TIMI) 血栓等级：低血栓负荷 (LTB; TIMI 0-3) 和高血栓负荷 (HTB; TIMI 4 和 5)。

结果

该研究包括 221 名患者，平均年龄为 63.3 ± 6.7 岁。与 LTB 患者相比，HTB 患者的 CHA ₂ DS ₂ -VASc 评分显着更高（p  < 0.001）。单变量和多变量回归分析表明，CHA ₂ DS ₂ -VASc 评分 (OR: 1.573, 95% CI: 1.153–2.147, p = 0.004) 作为 CHA ₂ DS ₂ - 的连续变量和二元截止水平VASc 评分 > 3 (OR: 3.876, 95% CI: 1.705–8.808, p  = 0.001) 与 HTB 显着相关。CHA ₂ DS _2的能力-通过受试者工作特征分析曲线分析评估预测 HTB 负担的 VASc 评分。根据 Youden 指数，预测 HTB的 CHA ₂ DS ₂ -VASc 评分的最佳截止值为3（敏感性为 67.9%，特异性为 69.3%）。

结论

CHA ₂ DS ₂ -VASc 评分可用作预测接受 SVG-PCI 的 AMI 患者 HTB 的简单实用工具。