Novel CHA2DS2-VASc-HSF as a Predictor In-Stent Restenosis in Coronary Artery Disease Patient After Stent Implantation
Ronaldi Rizkiawan1, Ivana Purnama Dewi2, Louisa Fadjri Kusuma Wardhani1, I Gde Rurus Suryawan3, Andrianto Andrianto1
Dr. Soetomo General Hospital, Indonesia1, Duta Wacana Christian University, Indonesia2, Dr. Soetomo Academic General Hospital, Indonesia3
In-stent restenosis (ISR) is a limitation of percutaneous coronary intervention that has been connected to various clinical and angiographic factors. To date, drug-eluting stents (DES) have significantly reduced the ISR rate. Some prediction models have been developed to considerably reduce ISR incidents. This study aims to assess the prognostic value of Gensini, CHA2DS2-VASc, and CHA2DS2-VASc-HSF scores on ISR in patients who had DES implantation for coronary heart disease (CAD).
We have done a retrospective study for all patients who underwent DES implantations at Integrated Cardiac Care Center, Dr. Soetomo Hospital, Surabaya, Indonesia, between January 2020 and October 2022. ISR was defined as a diameter stenosis of ≥50% within a coronary stent. Demographic, clinical data and angiographic characteristics were collected to calculate Gensini, CHA2DS2-VASc, and CHA2DS2-VASc-HSF scores. Statistical analyses were done using MedCalc 18.2.1. and SPSS 25.0.
We enrolled total 335 patients (mean age 58.56 ± 10.92 years and 81.2% were men) who underwent angiography and DES implantation. The patients were divided into 2 groups; ISR (n = 89) and non-ISR (n = 246). The mean CHA2DS2-VASc and CHA2DS2-VASc-HSF scores were higher for ISR group (3.31 ± 1.25 vs 2.65 ± 1.07; p < 0.001 and 4.99 ± 1.19 vs 3.75 ± 1.08; p < 0.001, respectively). From ROC curve, it is shown that CHA2DS2-VASc-HSF score has highest area under the curve (AUC) compared to Gensini and CHA2DS2-VASc score (AUC 0.78, 95% CI 0.727–0.842; p < 0.001).
CHA2DS2-VASc-HSF score has better ability to predict ISR compared to Gensini score and CHA2DS2-VASc score. Thus, this score can be used as a simple and effective tool to predict ISR in patients undergoing DES implantation.