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International Angiology 2020 Nov 03

DOI: 10.23736/S0392-9590.20.04498-3


lingua: Inglese

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

Zafer YALIM 1 , Mustafa ALDEMIR 2, Sümeyra ALAN YALIM 3

1 Department of Cardiology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey; 2 Department of Cardiovascular Surgery, Health Sciences University Bursa Higher Specialization Training And Research Hospital, Bursa, Turkey; 3 Department of İnternal Medicine, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey


BACKGROUND: The CHA₂DS₂-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 CHA₂DS₂-VASc score can predict adverse clinical outcomes in coronary artery disease, stroke, and many diseases irrespective of the presence of AF. The usefulness of CHA₂DS₂-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 CHA₂DS₂-VASc score for mortality of PAD patients.
METHODS: 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 CHA₂DS₂VASc 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.
RESULTS: The mean ages of group-1 and group-2 were 76.6 ± 0.81 and 66.5 ± 0.83 (p=0.007), respectively. The CHA₂DS₂VASc 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 CHA₂DS₂VASc score and death was determined in Spearman correlation (R:0.454, p<0.001). According to multivariate cox regression analysis, CHA₂DS₂-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.
CONCLUSIONS: The CHA₂DS₂VASc score is directly related with mortality in PAD patients. The CHA₂DS₂VASc 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 CHA₂DS₂VASc score in PAD.

KEY WORDS: CHA₂DS₂-VASc Score; Peripheral artery disease; Mortality

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