CHADS₂ and CHA₂DS₂Vasc-Score in Peripheral Systemic Embolism

Objectives: We analysed the characteristics of patients with an acute peripheral embolic event considering the possible use of the CHADS2-Score and the CHA₂DS₂Vasc-Score Patients and Methods: We retrospectively analyzed 163 cases of acute peripheral arterial embolism treated in the Department of Vascular Medicine of the HELIOS Klinik Krefeld, Germany, from 2008 to 2011. We retrospectively screened the medical form for information regarding atrail fibrillation (AF) and the risk factors necessary to calculate the CHADS₂ and CHA₂DS₂vasc score. Results: Arterial hypertension and age > 75 years were the most frequent risk factors. Mean CHADS₂ score was similar in males and females (2.3 ± 1.5 and 2.3 ± 1.4). 66% of the males and 63.3% of the females scored 2 and more points. Mean CHA₂DS₂Vasc score was 3.6 ± 2.0 in males and 4.6 ± 1.9 in females. 85.2% of the males and 95.4% of the females scored more than 2 points. In the medical forms AF was documented in 79 (48%) patients, of which 23 (43 %) were males and 56 (51%) females. Mean CHADS₂ score and mean CHA₂DS₂Vasc score were slightly higher in those with AF compared to the total group, but not significantly different. The rate of patients with 2 and more points increased for both scores: CHADS₂ score: males 82.6% and females 76.8%, CHA₂DS₂Vasc: males 100% and females 98.2%. Almost half of the patients with AF had had anticoagulation with phenprocoumon before (males 12 (52%), females 24 (43%), but only every 10th was within the therapeutic range (INR ≥2) Conclusion: The number of those with AF is high amongst patients with acute peripheral embolism. According to the CHADS₂ and CHA₂DS₂Vasc score, most of these patients had an indication for oral anticoagulation independent form the embolic event.