Superiority of CHA2DS2-VASc-HSF Score to CHADS2 and CHA2DS2-VASc Scores for Predicting the Severity of Coronary Artery Disease; a Cross-sectional Study

Abstract

Background: The degree of coronary artery disease (CAD) can be predicted using a variety of risk score techniques. However, their use in primary care settings is limited because most of them are complicated and call for sophisticated tools. A new risk score called CHA2DS2-VASc-HSF based on the CHA2DS2-VASc score was developed. Aim of the current study is to compare the efficacy of CHA2DS2-VASc-HSF score versus CHADS2 and CHA2DS2-VASc scores for the prediction of severity of coronary artery disease (CAD) to improve the management of CAD patients. Methods: This study was carried out in a cross-sectional fashion including 162 patients undergoing elective coronary angiography. Assessment of CHA2DS2-VASc-HSF, CHADS2 and CHA2DS2-VASc scores. Severity of CAD was assessed for all patients using Syntax score. Results: Syntax score was significantly higher among CHADS2 >1 group, CHA2DS2-VASc ‎‎>2 group and CHA2DS2-VASc-HSF >4 group (P<0.001).‎ There was a significant positive correlation between Syntax score with both ‎CHA2DS2-VASc (r=0.572, P<0.001) and CHA2DS2-VASc-HSF (r=0.420, ‎P<0.001).‎ Also, on conducting ROC analysis on CHADS2-VASc-HSF score, analysis showed that CHADS2-VASc-HSF score had highest sensitivity (88.39%) and specificity (85.71%) at 4 with area under the curve was (0.907). After applying logistic regression analysis for predictors of high Syntax score (>22); CHA2DS2-VASc-HSF can be used as independent factor for predicting high Syntax score with more significant p value than CHA2DS2-VASc score (P=0.006 vs P=0.02). Conclusion: Our study concluded that CHA2DS2-VASc-HSF score is superior to CHADS2, CHA2DS2-VASc for prediction of CAD severity.