CHA2DS2-VASC SCORE AS A NOVEL PREDICTOR FOR CONTRAST-INDUCED NEPHROPATHY AFTER PERCUTANEOUS CORONARY INTERVENTION IN ACUTE CORONARY SYNDROME

Abstract

Objective:This study aims at analyzing the predictive value of the CHA2DS2-VASc score as a simpler
tool for predicting CIN in patients with ACS undergoing PCI.
Background:CHA2DS2-VASc is a prediction tool for the risk of stroke in patients with atrial
fibrillation.It is a composite scoring system including congestive heart failure (CHF)/left ventricular
dysfunction, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age 65–
74 years, and sex (female).
Patients and method: This study included 130 patients presented with the acute coronary syndrome
who underwent percutaneous coronary intervention atthe cardiology department of Menoufia
University and the national heart institute from September 2019 to May 2021. CHA2DS2 VASC score
was calculated for each patient. Patientswere divided into two groups as group 1(patients who did not
develop CIN) while group 2 (patients who developedCIN).Whole History taking, thorough clinical
examination, echocardiography, and laboratory investigations were done for all patients included in
this study.serum creatinine at admission & 48 hrs after PCI were done to search for CIN . CIN was
defined as increase in serum creatinine level more than 0.5 mg /dl or more than 25% increase from
baseline within 48 h after PCI.
Results:There wasa significant difference between studied groups as regards CHA2DS2 VASCscore.
The cutoff value ofthe CHA2DS2 VASC score for the prediction of contrast-induced nephropathy
cases is 4 with sensitivity of 69.57%&specifity of 76.64%.
Conclusion:CHA2DS2-VASc score serves as a simple yet effective tool for predicting CIN preprocedure, which can be easily implemented in day-to-day clinical practice.