Predicting the Likelihood for Severe CAD and CABG Indication on Elective Patients: Comparison of Novel CHA2DS2-VASc-HSF with CHA2DS2 and CHA2DS2-VASc Score

Abundant scoring systems are available to assess the severity of coronary artery disease (CAD) and its intervention. However, the majority of them require advanced technologies. CHA₂DS₂-VASc-HSF is a novel and simple risk scoring, easily used for screening in primary care level. We hypothesize that CHA₂DS₂-VASc-HSF is predictive for severe CAD and indicative for coronary artery bypass grafting (CABG). Additionally, we compared its predictive value with CHA₂DS₂ and CHA₂DS₂-VASc score. A total of 210 consecutive patients who underwent elective coronary angiography were enrolled in our study. Anthropometric, laboratory, angiographic findings, and patient history were obtained from medical records and used to calculate CHA₂DS₂, CHA₂DS₂-VASc, and CHA₂DS₂-VASc-HSF score. Severe CAD is defined as Gensini Score >20. CABG indication was defined based on Class I recommendation from the American Heart Association (AHA). Statistical analyses were done using SPSS 25.0. Receiver operating characteristic (ROC) curve analysis showed the CHA₂DS₂ score (AUC [Area Under the Curve], 0.630; 95% CI, 0.555–0.706; p = 0.001), CHA₂DS₂-VASc score (AUC, 0.680; 95% CI, 0.608–0.752; p=0.000), and CHA₂DS₂-VASc-HSF score (AUC, 0.785; 95% CI, 0.723–0.846; p=0.000) were predictive of severe CAD. CHA₂DS₂-VASc-HSF score (AUC, 0.841; 95% CI, 0.711–0.971; p=0.00) were predictive of CABG indication. The CHA₂DS₂-VASc-HSF score provides the highest predictive value for severe CAD and CABG indication compared to the CHA₂DS₂ and CHA₂DS₂-VASc score, suggesting that CHA₂DS₂-VASc-HSF score may be used in primary care settings to suggest referral for coronary angiography and predict CABG possibilities.