Predictive value of the CHA2DS2-VASc Score in detecting in-stent restenosis among patients who underwent previous revascularization due to stable angina or acute coronary syndromes

Abstract

Background: Introduction of coronary stents in the field of interventional cardiology has significantly improved short- and long-term results of the percutaneous coronary interventions but in the same time they became responsible for development of a new entity called neo-intimal hyperplasia (NIH). If overexpressed, NIH can lead to so-called in-stent restenosis (ISR). Objective: To assess the predictive value of the CHA2DS2-VASc Score in detecting in-stent restenosis among patients who underwent previous revascularization in Proximal Left Anterior Descending(LAD) Artery using Drug Eluting Stents (DES) due to stable angina and acute coronary syndrome. Material and Methods: This study was conducted over 113 pateints to assess the predictive value of the CHA2DS2-VASc Score in detecting in-stent restenosis among patients who underwent previous revascularization in Proximal Left Anterior Descending (LAD) Artery using Drug Eluting Stents (DES). Results: From the study population collected(n=113), 18.4% of which were females (n=21), statistically significant relation was found between DES-ISR and CHADSVasc score (p value =0.033). A significant relationship existed between ISR and CHADVasc score 3 or more, and each of: Age(p value= 0.022), DM(p value=0.029), SBP during the procedure(p value = 0.036), time since the PCI was done(p value =0.001), stent length(p value =0.028), pattern of the lesion and management of the lesions as individual variables (p value less than0.001). However, nonsignificant relationship could be concluded between ISR and each of gender(p value= 0.987), CHF(p value=0.163), HTN(p value =0.446), vascular diseases (p value=0.662), CAD type (SCAD or ACS)(p value=0.616), DBP during the procedure(p value=0.167), creatinine clearance (p value=0.69), HBA1c(p value=0.091), use of DAPT(p value=0.198), the duration of DAPT use(p value =0.873), type of P2Y12 inhibitor used(p value=0.083), use of statins(p value=0.402), beta blockers or nitrates (p values= 1 & 0.836, respectively) and stent diameter used (p value=0.615) Conclusion: This study was able to show a significant relationship between ISR and each of CHADVasc score, Age, DM, SBP during the procedure, time since the PCI was done, stent length used, pattern of the lesion and management of the lesions.