CHA2DS2-VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule-out

BACKGROUND: Chest-pain patients deemed safe for discharge from internal medicine wards might still be at risk for adverse outcomes. HYPOTHESIS: CHA2 DS2 -VASc score improves risk stratification of low-risk chest-pain patients discharged after acute coronary syndrome (ACS) rule-out. METHODS: We accessed medical records of patients who were admitted to internal medicine wards at a single medical center during 2010-2016 and discharged following an ACS rule-out. Patients were classified according to CHA2 DS2 -VASc score: 0-1 (low), 2-3 (intermediate), >3 (high). Primary endpoint was occurrence of ACS at 1 year; 30-day and 1-year all-cause mortality (ACM) were secondary outcomes. RESULTS: Of 12 449 patients, 7057 (57%) had low, 3781 (30%) intermediate, and 1611 (13%) high CHA2 DS2 -VASc scores. Compared with a low score, intermediate and high scores were associated with significantly increased risk for 1-year ACS during the first year (OR: 2.89, 95% CI: 1.91-4.37, P  3) was associated with adverse outcomes among chest-pain patients discharged from internal medicine wards following ACS rule-out.