CHA2DS2-VASc Score as a Predictor of Cardiovascular and All-Cause Mortality in Chronic Kidney Disease Patients

Abstract

Introduction: Chronic kidney disease (CKD) is a risk factor for cardiovascular and all-cause mortality. Recognition of high-risk patients is important and could lead to a different approach and better treatment. The CHA₂DS₂-VASc score was originally used to predict cerebral infarction in patients with atrial fibrillation (AF), but it is also a useful predictor of outcome in other cardiovascular conditions, independent of AF. Therefore, the aim of our research was to assess the role of CHA₂DS₂-VASc score in predicting cardiovascular and all-cause mortality in CKD patients. Methods: Stable nondialysis CKD patients were included. At the time of inclusion, medical history data and standard blood results were collected and CHA₂DS₂-VASc score was calculated. Patients were followed till the same end date, until kidney transplantation or until their death. Results: Eighty-seven CKD patients were included (60.3 ± 12.8 years, 66% male). Mean follow-up time was 1,696.5 ± 564.6 days. During the follow-up, 21 patients died and 11 because of cardiovascular reasons. Univariate Cox regression analysis showed that CHA₂DS₂-VASc score is a significant predictor of cardiovascular and all-cause mortality. In multivariate Cox regression analysis, in which CHA₂DS₂-VASc score, serum creatinine, urinary albumin/creatinine, hemoglobin, high-sensitivity C-reactive protein, and intact parathyroid hormone were included, CHA₂DS₂-VASc score was an independent predictor of cardiovascular (HR: 2.04, CI: 1.20–3.45, p = 0.008) and all-cause mortality (HR: 2.06, CI: 1.43–2.97, p = 0.001). The same was true after adding total cholesterol, triglycerides, and smoking status to both the analyses. Conclusion: The CHA₂DS₂-VASc score is a simple, practical, and quick way to identify the risk for cardiovascular and all-cause mortality in CKD patients.