Association of CHA2DS2-VASc-HS Score with Adverse In-hospital Outcomes in Patients with Non-ST Segment Elevation Myocardial Infarction

Poppy Bala, Afzalur Rahman, Mohammad Ullah, Md Monsurul Haque, Khurshid Alam, Mohammad Arifur Rahman, Md Shariful Islam, Fathima Aaysha Cader, Md Golam Morshed, Kanu Bala, Delara Afroz

Background: Early detection of patients with non-ST segment elevation myocardial infarction (NSTEMI)
who would suffer from adverse in-hospital outcomes is important for the therapeutic decision. Recently it
was described that CHA2DS2-VASc-HS and CHA2DS2-VASc score is a predictor for severity and adverse
in-hospital outcomes in patients with stable coronary artery disease (CAD) and acute coronary syndrome.
The aim of our study was to assess the accuracy of the CHA2DS2-VASc-HS score predicting adverse inhospital outcomes in NSTEMI patients.
Methods: 120 patients with NSTEMI were enrolled in this study. The CHA2DS2-VASc-HS score was
calculated. The study subjects were divided into two groups. Patients’ with CHA2DS2-VASc-HS score>4
were put into group I and scored” 4 into group II. They were treated as per hospital treatment protocol and
followed-up for adverse in-hospital outcomes (Heart failure, cardiogenic shock, recurrent ischemic pain,
significant arrhythmia and death).
Results: It was observed that, patients with CHA2DS2-VASc-HS score >4 had more adverse in-hospital
outcomes than CHA2DS2-VASc-HS score d” 4 (20% vs. 3.3%, p=0.01). Group I patients developed cardiogenic
shock 10%, heart failure 4%, recurrent ischemia 11.7%, significant arrhythmia 1.7% and death 1.7% than
group II patients (1.7%, 3.3%, 3.3%, 0% and 0% respectively). By risk measurement, CHA2DS2-VASc-HS
score >4 emerged as a risk factor for developing adverse in-hospital outcome (Relative risk=6).
Conclusion: NSTEMI patients with high CHA2DS2-VASc-HS score have more adverse in-hospital outcomes.
This score, which involves only clinical parameters, can be used as a predictor of outcomes in this group
of patients.