Assessment of the relationship between death and CHA2DS2-VASc score in peripheral artery disease.

Abstract

The CHA<inf>2</inf>DS<inf>2</inf>-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age 65-74 years, female gender) score is used to estimate thromboembolic risk in atrial fibrillation (AF). Current studies have shown that CHA<inf>2</inf>DS<inf>2</inf>-VASc score can predict adverse clinical outcomes in coronary artery disease, stroke, and many diseases irrespective of the presence of AF. The usefulness of CHA<inf>2</inf>DS<inf>2</inf>-VASc score in predicting mortality of peripheral arterial disease (PAD) patients is unknown. In this study, we aimed to evaluate the predictive value of the CHA<inf>2</inf>DS<inf>2</inf>-VASc score for mortality of PAD patients. A total of 396 patients diagnosed with PAD for the first time in our clinic between January 2010-July 2016 were included in this study. Patients were divided into two groups as deceased (group 1, N.=153) and living (group 2, N.=243). A ROC analysis was performed to determine if CHA<inf>2</inf>DS<inf>2</inf>VASc score could predict the death events among PAD patients. Kaplan-Meier analysis was used to evaluate the timing of death events in the two groups. The mean ages of group 1 and group 2 were 76.6±0.81 and 66.5±0.83 (P=0.007), respectively. The CHA<inf>2</inf>DS<inf>2</inf>VASc scores of group-1 (4.37±0.1) and group 2 (2.96±0.9) were significantly different (P<0.001). A significant correlation between CHA<inf>2</inf>DS<inf>2</inf>VASc score and death was determined in Spearman correlation (R:0.454, P<0.001). According to multivariate cox regression analysis, CHA<inf>2</inf>DS<inf>2</inf>-VASc score [odds ratio (OR): 1.81 (95% CI: 1.42-2.30); P<0.001], Stroke [OR: 0.43 (95% CI: 0.21-0.85); P=0.016] and CRP [OR: 1.04 (95% CI: 1.01-1.06); P=0.002] were independent predictors of death. The CHA<inf>2</inf>DS<inf>2</inf>VASc score is directly related with mortality in PAD patients. The CHA<inf>2</inf>DS<inf>2</inf>VASc score may be a useful and practical scoring method to identify high-risk patients, and further future studies are needed to assess the role of CHA<inf>2</inf>DS<inf>2</inf>VASc score in PAD.