Comparative Study of Scores for Prediction of Coronary Artery Disease Severity: Evaluation of a Newly Formulated CHA2DS2-VASc-HSLp(a) Score
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 12
Abstract
ABSTRACT Introduction: The Framingham Risk Score (FRS) and CHA2DS2-VASc scores include risk factors for the development of Coronary Artery Disease (CAD). On review of literature, one study concluded that CHADS2, CHA2DS2-VASc, and especially CHA2DS2-VASc-HS scores could be considered predictive of the risk of severe CAD. CHA2DS2-VASc-HS score was made by adding hyperlipidaemia and smoking to CHA2DS2-VASc score. In developing countries like India, other than hyperlipidemia and smoking, Lipoprotein-(a) is an independent risk factor of CAD and adding Lipoprotein-(a) to CHA2DS2-VASc-HS score could be a better predictor of CAD in Indians. Aim: To formulate a new CHA2DS2-VASc-HSLp(a)) score by including hyperlipidemia, smoking and Lipoprotein-(a) and to compare it with FRS and CHA2DS2-VASc score. Hence to better predict CAD severity especially in developing countries like India. Materials and Methods: A total of 516 consecutive patients who underwent coronary angiography were enrolled in the study. Presence of >50% stenosis in a coronary artery was assessed as significant CAD. This study investigated whether these three scores can be used to predict CAD severity. Statistical analyses were conducted using the Statistical Package for the Social Sciences (SPSS version 16.0) for Windows (SPSS Inc., Chicago, Illinois). Results: Out of 516 patients, 31 had normal coronary angiograms or mild CAD. The remaining 485 patients with coronary stenosis were further classified into single, double and triple vessel disease. The FRS, CHA2DS2-VASc, and CHA2DS2-VASc-HSLp(a) Scores correlated significantly with the number of significant diseased vessels and highest predictive ability was found with CHA2DS2-VASc-HSLp(a) score (r=0.157, r=0.279, and r=0.461, p<0.001, respectively). The diagnostic accuracy and Positive predictive value were 87.2% and 97.7% obtained for CHA2DS2-VASc-HSLp(a) score with optimum Lp(a) cut-off ≥19 mg/dL. In addition, these three scores correlated significantly with the Gensini score and highest predictive ability was found with CHA2DS2-VASc-HSLp(a) score (r=0.194, r=0.459, and r=0.587, p<0.001 respectively). Conclusion: FRS, CHA2DS2-VASc, and especially CHA2DS2-VASc-HSLp(a) scores could be considered predictive of the risk of severe CAD. The CHA2DS2-VASc-HSLp(a) score was found to be the better scoring scheme to predict CAD severity in Indian population.
Authors and Affiliations
Bhupendra Kumar Sihag, Dharmendra Jain, Geetha Subramanian
Keywords
Related Articles
- EP ID EP526091
- DOI 10.7860/JCDR/2018/38052.12393
- Views 69
- Downloads 0
Stromal Expression of CD10 in Colorectal Carcinoma and its Correlation with Lymph Node Metastasis and Other Prognostic Factors
ABSTRACT Introduction: Colorectal Carcinoma (CRC) is an important public health problem. The study has been one of the main pre-occupation for researchers worldwide and continuous research is going on to find out methods...
Influence of Working Length on Post-operative Pain after Single or Two-visit Endodontic Treatment: A Randomised Clinical Trial
ABSTRACT Introduction: Microorganisms in the cemental canal can lead to the development of periapical lesions and its mechanical removal by means of overinstrumentation may be more favourable for the success of endodont...
Changing Trend of Clinical and Epidemiological Profile of Lung Cancer – Experience from a Tertiary Care Centre in Southern India
ABSTRACT Introduction: There has been a renewed interest in lung cancer epidemiology owing to changing trend in histology with a relative increase in adenocarcinoma worldwide. However, such a trend was not observed acro...
Impact of a Structured Tuberculosis Awareness Strategy on the Knowledge and Behaviour of the Families in a Slum Area in Chhattisgarh, India
Introduction: Of different methods of disease prevention, health education and awareness programmes can empower people regarding several aspects of disease management and thereby enabling them in accessing the right trea...
Gitelman Syndrome in a Case of Diabetic Kidney Disease: A Diagnostic and Therapeutic Dilemma
ABSTRACT Gitelman syndrome is an autosomal recessive disorder that usually presents with hypokalemia, hypomagnesemia, hypocalciuria and normal blood pressure. In contrast to Bartter syndrome it presents in late adulthood...