Andrianto Andrianto and Benny Jovie and Makhyan Jibril Al Farabi and Parama Gandi and Khubay Alvia Shonafi and Rofida Lathifah (2020) Novel CHA2DS2-VASc-HSF is Superior to CHADS2 and CHA2DS2-VASc Score to Predict the Risk of Severe Coronary Artery Disease. Scientific Foundation SPIROSKI.

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Abstract

BACKGROUND: Various risk scoring methods are available to predict the severity of coronary artery disease (CAD). However, the majority of them are complex and require advanced technologies, thus limiting its usage in primary care settings. CHA2DS2-VASc-HSF is a novel risk scoring which we develop from CHA2DS2-VASc score. AIM: We hypothesize that CHA2DS2-VASc-HSF is predictive for the risk of severe CAD, and we compare its validity with previously established CHADS2 and CHA2DS2-VASc score. MATERIALS AND METHODS: A total of 210 patients who underwent elective coronary angiography were enrolled in our study. Anthropometric, laboratory, angiographic findings, and patient history were obtained from medical records and used to calculate CHA2DS2-VASc-HSF score. Severe CAD defined as coronary artery occlusion with the Gensini score of ≥20. Statistical analyses were done using SPSS 25.0 and MedCalc 18.2.1. RESULTS: This research showed that the patient with severe CAD has significantly higher CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF score compared to normal and mild CAD (p < 0.001). CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF correlated significantly with the CAD severity (r = 0.315, p ≤ 0.001; r = 0.395, p ≤ 0.001; r = 0.612, p ≤ 0.001, respectively). CHA2DS2-VASc-HSF may predict the risk of severe CAD independent from other variables (odds ratio = 2.540; 95% confidence interval = 1.794–3.595; p = 0.002) with the cutoff value of ≥2.5 (sensitivity = 81.4% and specificity = 68.1%). Pairwise comparison of receiver operating characteristic curves showed that CHA2DS2-VASc-HSF was superior to predict severe CAD. CONCLUSIONS: CHA2DS2-VASc-HSF scores may predict the risk of severe CAD better than CHADS2 and CHA2DS2-VASc score. This score may easily be used in primary care physicians to predict the risk of severe CAD and provide an early referral to the cardiologist.

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