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CHA2DS2-VASc Score and Risk of New-Onset Peripheral Arterial Occlusive Disease in Patients without Atrial

Tzu-Chieh Lin1, Ho-Ming Su1,2,3, Wen-Hsien Lee1,2,3

  • 1Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University.

Acta Cardiologica Sinica
|May 12, 2021
PubMed

Insights

The CHA₂DS₂-VASc score effectively predicts new-onset peripheral artery occlusive disease (PAOD) in patients without atrial fibrillation. This score demonstrates superior predictive power compared to CHADS₂ and R₂CHADS₂ scores for identifying PAOD risk.

Area of Science:

  • Cardiovascular Medicine
  • Epidemiology
  • Vascular Disease Research

Background:

  • The CHA₂DS₂-VASc score is established for assessing stroke risk in atrial fibrillation (AF) patients, outperforming the CHADS₂ score.
  • Previous research indicated a correlation between the CHA₂DS₂-VASc score and reduced ankle-brachial index.
  • The current study investigates the predictive capability of the CHA₂DS₂-VASc score for new-onset peripheral artery occlusive disease (PAOD).

Purpose of the Study:

  • To determine if the CHA₂DS₂-VASc score can predict new-onset PAOD.
  • To compare the predictive performance of CHA₂DS₂-VASc score against CHADS₂ and R₂CHADS₂ scores for PAOD.
  • To evaluate the CHA₂DS₂-VASc score's utility in a general patient population without AF.

Main Methods:

  • Utilized the National Health Insurance Research Database, analyzing 723,750 patients from 2000-2001.
  • Calculated CHADS₂, R₂CHADS₂, and CHA₂DS₂-VASc scores for all patients.
  • Followed patients for new-onset PAOD over approximately 9.8 years, categorizing them by CHA₂DS₂-VASc score groups.

Main Results:

  • 24,775 patients (3.4%) developed new-onset PAOD during the follow-up period.
  • PAOD occurrence rates significantly increased with higher CHA₂DS₂-VASc scores, from 1.3% to 23.4%.
  • Multivariate analysis confirmed that CHA₂DS₂-VASc scores of 2-9 were significantly associated with new-onset PAOD, and the score outperformed CHADS₂ and R₂CHADS₂.

Conclusions:

  • The CHA₂DS₂-VASc score is a potent predictor of new-onset PAOD in individuals without atrial fibrillation.
  • It offers superior predictive accuracy for PAOD compared to the CHADS₂ and R₂CHADS₂ scores.
  • This finding supports the broader application of the CHA₂DS₂-VASc score in vascular risk assessment.
Abstract

Keywords:
CHA2DS2-VASc scoreCHADS2 scorePeripheral arterial occlusive diseaseR2CHADS2 score

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