Association between modified CHA2DS2-VASc Score with Ankle-Brachial index < 0.9

Abstract

The ankle-brachial index (ABI) is a reliable diagnostic examination for peripheral arterial occlusive disease (PAOD). We previously reported CHADS 2 score was significantly correlated with PAOD. However, the association between CHA 2 DS 2 -VASc score and ABI < 0.9 is not evaluated in the literature. The aim of the present study was to investigate whether CHA 2 DS 2 -VASc score has a strong association with PAOD. We enrolled 1482 patients in this study. PAOD was defined as ABI < 0.9 in either leg. Vascular disease in CHA 2 DS 2 -VASc score was modified as vascular disease except PAOD. Of the 1482 subjects, the prevalence of ABI < 0.9 was 5.6%. Multivariate analysis showed that the increased age, decreased estimated glomerular filtration rate and increased modified CHA 2 DS 2 -VASc score (OR, 1.764; p < 0.001) were independent associated with ABI < 0.9. In addition, the percentage of ABI < 0.9 in patients with modified CHA 2 DS 2 -VASc score of 0, 1, and <2 were 0%, 0.9%, and 0.7%, respectively (All < 1%). Our study demonstrated modified CHA 2 DS 2 -VASc score was significantly associated with ABI < 0.9. Calculation of modified CHA 2 DS 2 -VASc score might be useful in identifying patients with PAOD and in stratifying the risk of PAOD in non-AF patients.The ankle-brachial index (ABI) is a non-invasive and reliable diagnostic examination for peripheral arterial occlusive disease (PAOD) 1,2 . An ABI < 0.9 has not only been regarded as a reliable diagnostic tool for PAOD, but also a strong predictor for overall and cardiovascular mortality in different populations [3][4][5] . PAOD shares similar major risk factors with coronary artery disease (CAD) and cerebrovascular disease 6 . Patients with one vascular bed disease often have coexistent diseases in other vascular beds 7 . Patients with PAOD have increased cardiovascular morbidity and mortality especially for patients with critical limb ischemia 8,9 . Major risk factors for PAOD include advanced age, hypertension, diabetes mellitus, dyslipidemia, and smoking 6,10 . In addition, stroke, CAD, chronic kidney disease, races, gender, and heart failure were also reported to be associated with PAOD formation [11][12][13][14][15][16][17][18] . In our previous study, we found an association between CHADS 2 (congestive heart failure, hypertension, age ≧75 years, diabetes, prior stroke) score and ABI < 0.9 and confirmed CHADS 2 score was significantly associated with ABI < 0.9 in non-atrial fibrillation (AF) patients 19 . Additionally, using our National Health Insurance Research Dataset, we further demonstrated that CHADS 2 score was useful in predicting the risk of new-onset PAOD 20 . The CHADS 2 score is a simple and popular clinical score to assess the risk of stroke in patients with AF and there is a direct relationship between the CHADS 2 score and the annual risk of stroke in AF patients 21 . However, CHADS 2 score has several limitations. For example, some stroke risk factors were not included and patients with CHADS 2 score of 0 still had annual stroke rate >1.5%. Th...

Association between Rutherford Classification and CHA2DS2-VASc, CHADS2 and ASCVD Scores in Peripheral Artery Disease Patients

“…However, data on PAD on this issue are limited in the literature. In the studies of Hsu et al [13][14][15] evaluated the association between Ankle-Brachial Index (ABI) and CHADS 2 and modified CHA 2 DS 2 -VASc scores. In the first study, they showed that the association between CHADS 2 score and ABI < 0.9 and confirmed CHADS 2 score was significantly associated with ABI < 0.9 in non-AF patients [13].…”

“…After than they demonstrated that CHADS 2 score was useful in predicting the risk of new-onset PAD [14]. In their last study determined that modified CHA 2 DS 2 -VASc score was significantly associated with ABI < 0.9 and they argued that calculation of modified CHA 2 DS 2 -VASc score may be beneficial in recognizing patients with PAD and in graduating the risk of PAD [15]. In our study, the results are consistent with the results in these studies and as well as these scores, ASCVD score model has been shown to be related to the PAD stage.…”

CHADS2, CHA2DS2ASc, and New ABCD Scores Predict the Risk of Peripheral Arterial Disease in Patients with Sleep Apnea

“…Hsu et al reported that CHADS 2 score has good correlation with ankle-brachial index (ABI) <0.9 and it has good performance in predicting the risk of new onset PAD in patients without atrial fibrillation [10,11]. They also found that a modified CHA 2 DS 2 -VASc score, excluding peripheral arterial occlusive disease from the original vascular disease item, was significantly associated with ABI <0.9 [27]. In line with the studies by Hsu et al, we found that the risk of PAD was significantly increased with increasing CHADS 2 and CHA 2 DS 2 ASc scores in SA patients.…”

Συσχέτιση των διαστάσεων του αριστερού κόλπου με την τιμή του CHA2-DS2-VASc Score και την αρτηριακή σκληρία σε ασθενείς με κολπική μαρμαρυγή

“…Η παρατήρηση αυτή είναι σημαντική δεδομένου ότι και οι δύο δείκτες έχουν συσχετισθεί ανεξάρτητα με την πιθανότητα εκδήλωσης ΑΕΕ στους ασθενείς αυτούς. Τα αποτελέσματα αυτά έρχονται να προστεθούν στα ελάχιστα, μέχρι τώρα, και αντικρουόμενα δεδομένα που αφορούν στη σχέση αυτή(207)(208)(209)(210).Αφετέρου, για πρώτη φορά, τεκμηριώνει την ύπαρξη θετικής συσχέτισης μεταξύ του καρώτιδο -μηριαίου PWV και του CHA 2 DS 2 -VASc σκορ σε ασθενείς με ΚΜ.Στη διεθνή βιβλιογραφία υπάρχουν μικρές μελέτες που συγκρίνουν το CHA 2 DS 2 -VASc με διάφορες παραμέτρους της αγγειακής λειτουργίας, που με την ευρεία έννοια μπορούν να θεωρηθούν οτι αντικατοπτρίζουν την αρτηριακή σκληρία, και δείχνουν ότι ίσως υπάρχει θετική συσχέτιση των δύο μεγεθών(211)(212)(213). Η παρούσα μελέτη, όμως, απ' όσο γνωρίζουμε, είναι η πρώτη που εξετάζει τη σχέση του σκορ CHA 2 DS 2 -VASc με το PWV, το οποίο, όπως αναφέρθηκε, έχει συσχετιστεί σε μεγάλο αριθμό μελετών με την καρδιαγγειακή πρόγνωση.Δεδομένου οτι στον υπολογισμό του CHA 2 DS 2 -VASc δεν είναι όλοι οι παράγοντες ισότιμοι, η ανεύρεση συσχέτισης μεταξύ του σκορ (ανεξάρτητα από το ποιες επιμέρους συνιστώσες του υφίστανται σε κάθε ασθενή) και της αορτικής σκληρίας παρουσιάζει ιδιαίτερο ενδιαφέρον.Η συσχέτιση αυτή αξίζει να διερευνηθεί περαιτέρω προκειμένου να καθοριστεί η αξία του CHA 2 DS 2 -VASc στην πρόβλεψη της υψηλής αρτηριακής σκληρίας, τόσο σε ασθενείς με ΚΜ, όσο και στο γενικό πληθυσμό, ιδιαίτερα εφόσον ο υπολογισμός του σκορ αυτού είναι πολύ απλούστερος από τη μέτρηση της αρτηριακής σκληρίας.…”