Introduction
ST-elevation myocardial infarction (STEMI) has a high mortality rate, but emergency coronary revascularization has dramatically improved. In order to assess the short- and long-term risks of STEMI patients, many risk assessment scores have been developed for a wide range of patients and validated.The CHADS2 (congestive heart failure, hypertension, age >75 years, diabetes mellitus, and history of stroke [2 points]) score is the most widely used model for risk stratification of thromboembolism and selection of anticoagulation strategy in atrial fibrillation (AF). Recently, the CHA2DS2-VASc score was revised to improve risk stratification and to discriminate “true low-risk” and “high-risk” patients by adding 3 additional risk factors for thromboembolism as follows:age 65 to 74 years, female sex, and vascular diseases. Since our knowledge about the prognostic importance of the CHA2DS2-VASc score in STEMI patients who undergo a primary percutaneous coronary intervention (PCI), is insufficient, we investigated the prognostic significance of this score in this setting in terms of in-hospital and long-term all-cause and cardiovascular mortality regardless of whether the patients had AF or not.
Methods
In this prospective study, 604 patients (479 men and 125 women; range, 26–88 years [69 ± 12.3]), who were admitted to the emergency department of training and research hospital between December 2010 and November 2013 with a typical chest pain and/or dyspnea and resulting diagnosis of STEMI, were included. The study patients were divided into three groups according to their CHA2DS2-VASc score as follows:low-risk group (1 point), moderate-risk group (2 points), and high-risk group (3 points and higher). The primary and secondary end points of the study were all-cause and cardiovascular mortality respectively.
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