Prediction Of Coronary Artery Severity And In-hospital Prognosis In Acute Myocardial Infarction Patients Using CHADS₂,CHA₂DS₂-VASc And CHA₂DS₂-VASc-HS Scores

Objective To discuss the predictive factors of coronary artery severity and adverse events after PCI procedure in acute myocardial infarction patients,and determine the predictive value of CHADS₂,CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores in coronary artery severity and in-hospital prognosis after PCI procedure.Method 821 acute myocardial infarction patients are selected into this study.Basic information including sex,age,smoking history,past medical history,blood lipids and treatment are collected.According to the outcome of coronary angiography,all patients are divided into three groups?single,double,triple vessel disease?.Discuss the predictive factors of coronary artery severity and determine the predictive value of CHADS₂,CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores in multivessel disease.In patients with PCI procedure,discuss the predictive factors of in-hospital adverse events after PCI procedure.Determine the predictive value of CHADS₂,CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores in in-hospital adverse events after PCI procedure.Result 1.The rate of patients with female,old-age,hypertension,diabetes,stroke,peripheral artery disease,dyslipidemia and congestive heart failure increase with the coronary artery severity.Old-age,hypertension,stroke and dyslipidemia are independent risk factors of coronary artery severity.2.CHADS₂,CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores increase with the coronary artery severity.The area under curve of ROC in prediction of multivessel disease is 0.611,0.636 and 0.643 respectively.Compared CHADS₂ with CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS score,the difference of area under curve is statistically significant.3.The rate of female,old-age and congestive heart failure is higher in patients with adverse events after PCI procedure.Old-age and congestive heart failure are independent risk factors of in-hospital adverse events after PCI procedure.4.CHADS₂,CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores are higher in patients with adverse events after PCI procedure.The area under curve of ROC in prediction of in-hospital adverse events after PCI procedure is 0.638,0.667 and 0.656 respectively.No statistically significant exists among the area under curve of the three scores.Conclusion 1.Old-age,hypertension,stroke and dyslipidemia are independent risk factors of coronary artery severity in acute myocardial infarction patients.2.CHADS₂,CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores can predict multivessel disease.CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores have the better prediction value 3.Old-age and congestive heart failure are independent risk factors of inhospital adverse events after PCI procedure in acute myocardial infarction patients.4.CHADS₂ CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores can predict adverse events after PCI procedure in acute myocardial infarction patients equally.