Prognostic value of HELT-E2S2 score among patients undergoing percutaneous coronary intervention: sub-analysis of the SHINANO 5-year registry.

Abstract

The HELT-E₂S₂ score has recently been proposed as a new risk stratification tool for ischemic stroke in Japanese patients with atrial fibrillation (AF). We aimed to evaluate the prognostic value of HELT-E₂S₂ score for cardiovascular events among patients undergoing percutaneous coronary intervention (PCI). Between August 2012 and July 2013, patients undergoing PCI enrolled in the SHINANO 5-year registry, a prospective, observational multicenter registry, were analyzed for the current study. Primary endpoint was major adverse cardiovascular events (MACE), a composite of all-cause death, myocardial infarction, and ischemic stroke at 5 years. Key secondary endpoint was bleeding events at 5 years. A total of 1608 patients were divided into the low HELT-E₂S₂ score group (< 2, n = 915) and high HELT-E₂S₂ score group (≥ 2, n = 693). Major criteria of the HELT-E₂S₂ score were hypertension (74.7%), elderly age 75-84 years (31.3%), and AF (11.1%). Kaplan-Meier analysis revealed that the high HELT-E₂S₂ score group had a significantly higher incidence of MACE (33.4% vs. 14.8%, P < 0.001) and bleeding events (12.7% vs. 5.3%, P < 0.001) compared with the low HELT-E₂S₂ score group. Multivariable analysis demonstrated that the HELT-E₂S₂ score remained significantly associated with MACE (hazard ratio: 1.73, 95% confidence interval: 1.11-2.69; P = 0.015). The HELT-E₂S₂ score appears a useful tool for predicting future cardiovascular events in CAD patients undergoing PCI.