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CHADS2 and CHA2DS2Vasc-Score in Peripheral Systemic Embolism
Frans Santosa1, Thomas Nowak1, Theodoros Moysidis1
1Department of Vascular Medicine.
Patients with acute peripheral embolism often have atrial fibrillation (AF). Most patients with AF and peripheral embolism meet criteria for oral anticoagulation therapy based on CHADS2 and CHA2DS2-Vasc scores.
Area of Science:
- Vascular Medicine
- Cardiology
- Thrombosis
Background:
- Acute peripheral embolism is a significant clinical event.
- Risk stratification scores like CHADS2 and CHA2DS2-Vasc are used to assess stroke risk in atrial fibrillation patients.
Purpose of the Study:
- To analyze patient characteristics with acute peripheral embolic events.
- To evaluate the applicability of CHADS2 and CHA2DS2-Vasc scores in this patient group.
Main Methods:
- Retrospective analysis of 163 patients with acute peripheral arterial embolism (2008-2011).
- Screening of medical records for atrial fibrillation (AF) and risk factors for CHADS2 and CHA2DS2-Vasc scores.
Main Results:
- Hypertension and age >75 were common risk factors.
- Mean CHA2DS2-Vasc scores were 3.6 in males and 4.6 in females.
- 48% of patients had documented AF; most scored high on risk stratification scales.
- Inadequate anticoagulation (INR <2) was noted in 90% of AF patients on phenprocoumon.
Conclusions:
- A high prevalence of AF exists in patients with acute peripheral embolism.
- Most patients with AF and peripheral embolism qualify for oral anticoagulation based on risk scores.
- Current anticoagulation practices in these patients may be suboptimal.
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