Does CHA2DS2-VASc score predict mortality in chronic kidney disease?

Goudis, Christos A.; Daios, Stylianos; Korantzopoulos, Panagiotis; Liu, Tong

doi:10.1007/s11739-021-02799-5

Cited by 13 publications

(13 citation statements)

References 40 publications

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“…Finding a good performance of the CHA 2 DS 2 -VASc score in predicting mortality also among patients with chronic kidney disease makes this score broadly usable. 2,19 Several reports have more recently shown the usefulness of the addition of the renal function to the CHA 2 DS 2 -VASc score as a predictor of CV events and mortality in different settings in patients with or without AF. 20,21 It is worth reminding that several studies have shown that renal insufficiency is in its own right a strong and independent predictor of all-cause mortality in different patient settings.…”

Section: Discussionmentioning

confidence: 99%

“…Finding a good performance of the CHA 2 DS 2 ‐VASc score in predicting mortality also among patients with chronic kidney disease makes this score broadly usable 2,19 …”

Section: Discussionmentioning

confidence: 99%

“…The CHADS 2 score was introduced in 2006 by the ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation (AF) as a clinical predictive measure to estimate the cardioembolic risk in patients with AF 1 . It is a very simple, reproducible and precise score, validated by several studies, 2 based on the presence of specific stroke risk factors/modifiers. It is a point system in which 2 points are assigned for a history of stroke or transient ischaemic attack and 1 point each is assigned for age over 75 years, history of hypertension, diabetes mellitus or recent heart failure 3,4 .…”

Section: Introductionmentioning

confidence: 99%

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CHA2DS2‐VASc and R2CHA2DS2‐VASc scores predict mortality in high cardiovascular risk population

D’Errico

Piscitelli

Mirijello

et al. 2022

Eur J Clin Investigation

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Background The CHA2DS2‐VASc score, widely used to estimate cardioembolic risk in patients with atrial fibrillation (AF), appears to be useful also in predicting vascular adverse events and death in different sets of patients without AF. The R2CHA2DS2‐VASc score, which includes renal impairment, allows a better prediction of death and thromboembolism in patients without AF. The aims of our study were to assess, in a large sample of patients at high cardiovascular (CV) risk, (i) the correlation between CHA2DS2‐VASc and R2CHA2DS2‐VASc with all‐cause mortality, and (ii) to compare the performances of CHA2DS2‐VASc and R2CHA2DS2‐VASc in predicting all‐cause mortality. Methods In this single‐centre prospective observational study, conducted at the Research Hospital ‘Casa Sollievo della Sofferenza’ between June 2016 and December 2018, 1017 CV patients at high risk of undergoing coronary angiography were enrolled. Results CHA₂DS₂‐VASc and R2CHA2DS2‐VASc scores significantly associated with all‐cause mortality. For each one‐point increase in CHA2DS2‐VASc or R2CHA2DS2‐VASc scores, mortality increased by almost 1.5‐fold. The R2CHA2DS2‐VASc score (C‐statistic = 0.71; 95% CI = 0.65–76) outperformed the CHA2DS2‐VASc score (C‐statistic = 0.66; 95% CI = 0.61–0.71) in predicting 4‐year mortality (delta C‐statistic = 0.05; 95% CI = 0.02–0.07). The better predictive ability of the R‐CHA2DS2‐VASc score was also demonstrated by an IDI = 0.027 (95% CI = 0.021–0.034, p < .00001) and a relative IDI = 62.8% (95% CI = 47.9%–81.3%, p < .00001). The R2CHA2DS2‐VASc score correctly reclassified the patients with a NRI = 0.715 (95% = 0.544–0.940, p < .00001). Conclusions The CHA₂DS₂‐VASc and R2CHA2DS2‐VASc scores are useful predictors of all‐cause mortality in subjects at high CV risk, with the R2CHA2DS2‐VASc score being the best performer.

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Section: Discussionmentioning

confidence: 99%

“…Finding a good performance of the CHA 2 DS 2 ‐VASc score in predicting mortality also among patients with chronic kidney disease makes this score broadly usable 2,19 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

CHA2DS2‐VASc and R2CHA2DS2‐VASc scores predict mortality in high cardiovascular risk population

D’Errico

Piscitelli

Mirijello

et al. 2022

Eur J Clin Investigation

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“…Among the comorbidities more frequently associated with AF, chronic kidney disease (CKD) has special value, in consideration of the existing pathophysiological links, the influence of patient management, and treatments [ 4 ]. However, evidence gaps on the best strategies to adopt at specific stages of CKD are still present [ 1 , 4 , 5 , 6 ]. As a matter of fact, the stages of CKD, as proposed by Kidney Disease: Improving Global Outcomes (KDIGO) [ 4 , 7 , 8 ] are an important reference for clinical decisions and patients outcome in many cardiac diseases, both for medical and interventional treatments [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Chronic Kidney Disease with Mild and Mild to Moderate Reduction in Renal Function and Long-Term Recurrences of Atrial Fibrillation after Pulmonary Vein Cryoballoon Ablation

Boriani¹,

Iacopino²,

Arena³

et al. 2022

JCDD

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The aim of this research was to evaluate if patients with chronic kidney disease (CKD) and mild or mild to moderate depression of renal function have an increased risk of atrial fibrillation (AF) recurrences after cryoballoon (CB) ablation. We performed a retrospective analysis of AF patients undergoing pulmonary vein isolation (PVI) by CB. The cohort was divided according to the KDIGO CKD-EPI classification into a (1) normal, (2) mildly decreased, or (3) mild to moderate reduction in estimated glomerular filtration rate (eGFR). Freedom from AF recurrences was the primary endpoint. A total of 1971 patients were included (60 ± 10 years, 29.0% females, 73.6% paroxysmal AF) in the study. Acute success and complication rates were 99.2% and 3.7%, respectively, with no significant differences among the three groups. After a follow-up of 24 months, AF recurrences were higher in the mildly and mild to moderate CKD groups compared to the normal kidney function group (23.4% vs. 28.3% vs. 33.5%, p < 0.05). Mild to moderate CKD was an independent predictor of AF recurrences after the blanking period (hazard ratio:1.38, 95% CI 1.02–1.86, p = 0.037). In conclusion, a multicenter analysis of AF patients treated with cryoablation revealed mild to moderate reductions in renal functions were associated with a higher risk of AF recurrences. Conversely, the procedural success and complication rates were similar in patients with normal, mildly reduced, or mild to moderate reduction in eGFR.

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“…Together with the HAS-BLED score, CHA 2 DS 2 -VASc is used to estimate the thrombotic/hemorrhagic risk in patients requiring thromboprophylaxis such as those with nonvalvular atrial fibrillation [11]. Nonetheless, the CHA 2 DS 2 -VASc score was reported to predict mortality in different groups of patients and conditions including subjects with chronic kidney disease [12], after cardiac [13] and noncardiac surgery [14], and acute cerebrovascular events [15]. Recent findings showed that the CHA 2 DS 2 -VASc score and its modified forms can differentiate patients at higher risk of worse outcome in course of SARS-CoV-2 infection [16][17][18].…”

mentioning

confidence: 99%