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CHLD score, a new score based on traditional risk factor evaluation and long-term cardiovascular outcomes in patients

Klaudia Gieszczyk-Strózik1,2, Maciej T Wybraniec3,4, Małgorzata Widuchowska2,5

  • 1First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 47 Ziołowa St., 40-635, Katowice, Poland.

Scientific Reports
|October 2, 2021
PubMed

Insights

A new score combining chronic kidney disease, hypertension, hyperlipidemia, and diabetes (CHLD) effectively predicts major adverse cardiovascular events (MACE) in systemic sclerosis patients without pulmonary hypertension.

Area of Science:

  • Cardiology
  • Rheumatology
  • Clinical Prediction Models

Background:

  • Systemic sclerosis (SSc) patients without pulmonary arterial hypertension face significant cardiovascular risks.
  • Identifying reliable predictors of major adverse cardiovascular events (MACE) is crucial for managing SSc patients.
  • Existing risk stratification models may not fully capture cardiovascular risk in this specific SSc population.

Purpose of the Study:

  • To identify independent predictors of MACE in patients with SSc, excluding those with pulmonary arterial hypertension.
  • To develop and validate a predictive score for long-term cardiovascular outcomes in this patient group.

Main Methods:

  • A cohort of 68 SSc patients without pulmonary arterial hypertension was followed for a median of 99 months.
  • Baseline assessments included cardiovascular risk factors, 6-min walk test, echocardiography, and GDF-15 levels.
  • MACE was defined as death, myocardial infarction, revascularization, or heart failure hospitalization.

Main Results:

  • Chronic kidney disease, lung fibrosis, and GDF-15 were identified as independent MACE predictors at baseline.
  • The developed CHLD score (Chronic kidney disease, Hypertension, hyperLipidaemia, Diabetes mellitus) emerged as the sole independent predictor of MACE.
  • Each point increase in the CHLD score significantly elevated the risk of MACE (HR 3.46).

Conclusions:

  • The CHLD score is a reliable and independent predictor of long-term MACE in SSc patients without pulmonary arterial hypertension.
  • Integrating traditional risk factors into the CHLD score improves cardiovascular risk assessment in this population.
  • This score can aid in proactive management and risk stratification for SSc patients.

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