The Relation Between CHA2DS2-VASc Score,Initial TIMI Flow Grades and In-Hospital Mortality in Patients Presenting with Acute Myocardial Infarction

Abstract

The CHA₂DS₂-VASc score includes classical risk factors (e.g., Congestive heart failure/Left ventricle dysfunction, Hypertension, Age, Diabetes mellitus, Stroke/Transient ischemic attack/Thromboembolism, Vascular disease and Sex) for coronary artery disease. We investigated the association between initial thrombolysis in myocardial infarction (TIMI) flow of the culprit artery and CHA₂DS₂-VASc score and in-hospital clinical outcomes in patients presenting with acute myocardial infarction (AMI). Initial and postprocedural TIMI flow grades were recorded in patients hospitalized with first diagnosis of AMI. The initial TIMI flow grades and CHA₂DS₂VASC scores were compared with the post-procedural TIMI flow grades. Patients (n = 750) were included retrospectively; 56.7% was in the low flow (TIMI 0-1) and 43.3% was in the high flow (TIMI 2-3) group. The CHA₂DS₂-VASc score was higher (P < .001) in the low flow group. The best CHA₂DS₂-VASc score cut-off value was 3 to predict initial TIMI flow. Median CHA₂DS₂-VASc score was 4 in-hospital mortality group (P < .001) and this score was an independent predictor of in-hospital mortality. The CHA₂DS₂-VASc score was an independent predictor of low initial TIMI flow and in-hospital mortality. Patients with high preprocedural CHA₂DS₂-VASc tended to have low coronary flow grades and higher mortality rates.