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

Abstract

Background: The CHA(2)DS(2)-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(2)DS(2)-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(2)DS(2)-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(2)DS(2)-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 CHA(2)DS(2)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. Results: The mean ages of group 1 and group 2 were 76.6 +/- 0.81 and 66.50.83 (P=0.007), respectively. The CHA(2)DS(2)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(2)DS(2)VASc score and death was determined in Spearman correlation (R:0.454, P<0.001). According to multivariate cox regression analysis, CHA(2)DS(2)-VASc score [odds ratio (OR): 1.81 (95% CI: 1.42-2.30); P<0.0011, Stroke [OR: 0.43 (95% Cl: 0.21-0.85); P=0.016] and CRP [OR: 1.04 (95% CI: 1.01-1.06); P=0.0021 were independent predictors of death. Conclusions: The CHA(2)DS(2)VASc score is directly related with mortality in PAD patients. The CHA(2)DS(2)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(2)DS(2)VASc score in PAD.