Objective To investigate the values of CHA2DS2-VASc score and the Global Registry of Acute Coronary Events (GRACE) risk score in predicting the poor prognosis of patients with atrial fibrillation after percutaneous coronary intervention (PCI).
Methods A total of 180 patients diagnosed as atrial fibrillation and treated with PCI were selected as research objects, and CHA2DS2-VASc score and GRACE risk score were evaluated after hospital admission. Patients were followed up for 12 months, with the major adverse cardiac events (MACE) as the primary outcome index and all-cause mortality as the secondary outcome index. The patients were divided into different subgroups according to the occurrence of MACE and death, and the general materials were compared between subgroups. Cox proportional hazard model was used to evaluate the values of CHA2DS2-VASc score and GRACE risk score in predicting outcome indexes. The receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC) was calculated, and the predictive efficiencies of CHA2DS2-VASc score and GRACE risk score for outcome indexes were evaluated.
Results A total of 21 patients (11.7%) with MACE were enrolled in the MACE group, and 159 patients without MACE were enrolled in the non-MACE group; the age, incidence of congestive heart failure, CHA2DS2-VASc score and GRACE risk score in the MACE group were significantly higher than those in the non-MACE group (P < 0.05). A total of 10 dead patients (5.6%) were enrolled in the death group, and the 170 survival patients were enrolled in the survival group; the age, CHA2DS2-VASc score and GRACE risk score in the death group were significantly higher than those in the survival group (P < 0.05). Cox proportional hazard model showed that the increases of CHA2DS2-VASc score and GRACE risk score were related to the increase of risk of MACE (HR=2.056, 1.076; 95%CI, 1.558 to 2.713, 1.048 to 1.104; P < 0.001), and the increases of CHA2DS2-VASc score and GRACE risk score were also significantly associated with the increase of all-cause mortality (HR=2.949, 1.114; 95%CI, 1.983 to 4.387, 1.067 to 1.163; P < 0.001). ROC curve showed that the AUC values of CHA2DS2-VASc score combined with GRACE risk score in predicting MACE and all-cause mortality were 0.856 and 0.943 respectively, the sensitivity values were 85.7% and 80.0% respectively, and specificity values were 73.0% and 90.6% respectively.
Conclusion Increase of CHA2DS2-VASc score and GRACE risk score is associated with increase of risks of MACE and all-cause mortality in patients with atrial fibrillation after PCI, and the combination of the two scoring methods has high predictive values for MACE and all-cause mortality in patients with atrial fibrillation after PCI.
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