Comprehensive Explanation:
The CHA2DS2-VASc-ACS Score is an adaptation of the original CHA2DS2-VASc risk model—initially used for atrial fibrillation—to evaluate cardiovascular and cerebrovascular risk in patients with acute coronary syndrome (ACS) or post-myocardial infarction (MI).
Higher scores indicate greater burden of systemic vascular disease and increased likelihood of recurrent events or mortality after MI.
Components: Congestive heart failure/LV dysfunction (1), Hypertension (1), Age >75 years (2), Diabetes mellitus (1), Prior stroke/TIA (2), Vascular disease (1), Age 65–74 years (1), Female sex (1).
Clinical Interpretation:
Patients with higher CHA2DS2-VASc scores after MI are more prone to major adverse cardiovascular events (MACE), reinfarction, and mortality.
It reflects the cumulative burden of atherosclerosis and comorbidity in secondary prevention.
This score complements but does not replace ACS-specific risk models such as GRACE or TIMI.
References:
- Chua SK et al. Use of CHADS2 and CHA2DS2-VASc Scores to Predict Myocardial Infarction, Stroke, and Death in Acute Coronary Syndrome Patients. PLoS One. 2014;9(12):e114116.
- Zhang QY et al. New CHA2DS2-VASc-HSF score predicts no-reflow and outcome in MI. BMC Cardiovasc Disord. 2020;20:423.
- Chou CY et al. CHA2DS2-VASc score to predict the risk of future acute coronary events in patients recovering from AMI. Int J Cardiol. 2020.