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The Relationship Between the CHA2DS2-VASc Score and Lesion Complexity and Long-Term Outcomes in Peripheral Arterial

Ali Evsen1, Adem Aktan2, Raif Kılıç2

  • 1Department of Cardiology, Dağkapı State Hospital, Diyarbakır, Turkiye.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|September 8, 2025
PubMed

Insights

The CHA2DS2-VASc score predicts lesion severity and long-term survival in peripheral artery disease (PAD) patients. Higher scores indicate increased risk for PAD complications and mortality.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Medical Prognostics

Background:

  • The CHA2DS2-VASc score, initially for atrial fibrillation stroke risk, is now used for broader cardiovascular prognostication.
  • Peripheral artery disease (PAD) significantly impacts patient morbidity and mortality.
  • Evaluating predictive tools for PAD outcomes is crucial for patient management.

Purpose of the Study:

  • To assess the CHA2DS2-VASc score's predictive capability for lesion severity in PAD patients.
  • To determine the association between the CHA2DS2-VASc score and long-term survival outcomes in PAD.
  • To explore the utility of a widely used cardiovascular risk score in a different vascular disease context.

Main Methods:

  • Retrospective analysis of 784 PAD patients diagnosed via CT angiography.
  • Calculation of CHA2DS2-VASc scores for all participants.
  • Assessment of lesion severity using TASC II criteria and categorization into simple (TASC-AB) and complex (TASC-CD) groups.
  • Long-term mortality data collected from hospital and social security records.

Main Results:

  • CHA2DS2-VASc score and left ventricular ejection fraction were independent predictors of lesion severity (P < 0.007 and P = 0.009, respectively).
  • A CHA2DS2-VASc score threshold of 3.5 predicted long-term mortality with 70% sensitivity and 79% specificity (P < 0.001).
  • Kaplan-Meier analysis revealed significantly lower survival rates in patients with higher CHA2DS2-VASc scores over 60 months (P < 0.001).

Conclusions:

  • The CHA2DS2-VASc score is an independent predictor of lesion severity in PAD.
  • Higher CHA2DS2-VASc scores are associated with adverse long-term outcomes and reduced survival in PAD patients.
  • The CHA2DS2-VASc score demonstrates prognostic value beyond its original indication, extending to peripheral artery disease.
Abstract

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