The Role of CHA₂DS₂-VASc Score in Predicting Clinical Complications Following Primary Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.

Abstract

Background: The CHA₂DS₂-VASc score was originally developed to assess stroke risk in patients with atrial fibrillation (AF). Recently, it has been explored as a potential tool for predicting adverse cardiovascular outcomes after percutaneous coronary intervention (PCI). However, its effectiveness in this context remains underexplored.

Aims: This review aims to evaluate the ability of the CHA₂DS₂-VASc score to predict adverse cardiovascular outcomes in patients undergoing PCI.

Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Ten observational studies involving a total of 14,143 patients were included. The primary outcomes were ISR, AST, and MACE. Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models.

Results: Most included studies were observational with varying endpoints, follow-up periods, and stent technologies, limiting causal inference, subgroup analyses, and introducing potential bias. The pooled analysis showed that higher CHA₂DS₂-VASc scores were significantly associated with increased risks of ISR (OR: 2.21; 95% CI: 1.75-2.78), AST (OR: 1.99; 95% CI: 1.53-2.60), and MACE (HR: 1.44; 95% CI: 1.22-1.69).

Conclusion: The CHA₂DS₂-VASc score shows strong predictive value for ISR, AST, and MACE after PCI. Its simplicity and ease of use make it a practical tool for bedside risk assessment in clinical settings. Future prospective, multicenter studies with patient-level data are needed to validate the CHA₂DS₂-VASc score in non-AF populations.