Examination of the predictiveness of CHA2DS2-VASc and CHA2DS2-VASc-HSF scoring systems in the progosis evaluation of patients with severe aortic stenosis

OBJECTIVES: Aortic stenosis (AS) is the most common primary valve disease requiring surgical or transcatheter intervention in Europe and North America. Studies have shown an association between atherosclerotic risk factors and the development of calcific AS. There are studies evaluating the relationship between CHA2DS2-VASc and CHA2DS2-VASc-HSF score systems and atherosclerotic heart disease. In this study, we aimed to investigate the prognostic value of CHA2DS2-VASc and CHA2DS2-VASc-HSF score systems in patients with severe AS without surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Materials and Methods: In this study, hospital data between 2010 and 2023 were retrospectively analyzed for patients diagnosed with severe AS without SAVR or TAVR. The CHA2DS2-VASc and CHA2DS2-VASc-HSF scores of the patients were calculated and their association with the development of stroke, myocardial infarction (MI), atrial fibrillation (AF), heart failure (HF), and cardiovascular (CV) sudden death during at least 2 years of follow-up was evaluated. Results: The study included 129 patients. The mean age of the patients was 76.910.8 years and 65.9% were female. The mean CHA2DS2-VASc score was 4.41.8 and the mean CHA2DS2-VASc-HSF score was 4.82. Stroke was observed in 5.4% of patients, MI in 13.2%, AF in 35.7%, HF in 47.3% and CV sudden death in 14%. CHA2DS2-VASc score of ≥5 and CHA2DS2-VASc-HSF score of ≥6 were statistically significant in predicting the development of MI (p=0.011, p=0.018, respectively). CHA2DS2-VASc and CHA2DS2-VASc-HSF scores of ≥5 were statistically significant in predicting the development of HF (p <0.001). Conclusion: We concluded that CHA2DS2-VASc and CHA2DS2-VASc-HSF scoring systems can be used as predictors of prognosis, especially HF and MI in patients with severe AS without SAVR or TAVR. Keywords: Aortic stenosis, Prognosis, CHA2DS2-VASc, CHA2DS2-VASc-HSF