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

Yalım, Zafer; Aldemir, Mustafa; Yalım, Sümeyra Alan

doi:10.23736/s0392-9590.20.04498-3

Cited by 7 publications

(9 citation statements)

References 21 publications

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“…[1][2][3] Other recent studies have also demonstrated the prognostic value of CHA 2 DS 2 -VASc score in various cardiovascular and noncardiovascular diseases, for clinical outcomes beyond stroke such as death, major adverse cardiovascular events, heart failure hospitalisations and cardiac hospitalisations. [4][5][6][7][8][9][10] Most of the patients in these studies have established cardiovascular diseases, are hospitalised and/ or undergoing cardiovascular procedures, whereas our study differs with having a large proportion of patients who are stable outpatients. Even so, the CHA 2 DS 2 -VASc score was an important risk prognosticator in our lower risk population, and this comes as no surprise given that most of the CHA 2 DS 2 -VASc components are known cardiovascular risk factors.…”

Section: Discussionmentioning

confidence: 97%

“…[1][2][3] A number of contemporary studies have reported the CHA 2 DS 2 -VASc score to be associated with adverse clinical outcomes in a variety of cardiovascular diseases beyond AF, such as heart failure, acute coronary syndrome, hypertension, cerebrovascular disease, peripheral arterial disease and even non-cardiovascular disease like chronic obstructive pulmonary disease and COVID-19 infection. [4][5][6][7][8][9][10] Whether the CHA 2 DS 2 -VASc score stratify mortality risk in both patients with AF and without AF (non-AF), regardless of the number of co-morbidities, is not well established, but important to investigate given recent interests in clinical electronic medical records (EMR) embedded calculator based risk prediction in general populations. Patients undergoing stress tests are a relatively low-risk cohort compared with those with established cardiovascular disease, and are often referred for risk stratification.…”

Section: Introductionmentioning

confidence: 99%

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CHA₂DS₂-VASc score stratifies mortality risk in patients with and without atrial fibrillation

et al. 2021

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ObjectivesThe CHA2DS2-VASc score is the preferred risk model for anticoagulation decision-making in atrial fibrillation (AF) patients. Recent studies have found this score to have prognostic value in other cardiovascular diseases. We assessed the relationships between CHA2DS2-VASc score and long-term mortality in adults referred for stress testing,Methods165 184 consecutive patients from January 1991 to December 2014 from a prospective registry were studied, with CHA2DS2-VASc score calculated for all patients, and AF and anticoagulation status were recorded. The primary endpoint was all-cause mortality.ResultsIn this cohort, 12 450 (7.5%) patients had AF and mean CHA2DS2-VASc score was 2.2±1.2. There were 22 152 (18.4%) deaths during mean follow-up of 6.1±4.8 years. In multivariable analysis, CHA2DS2-VASc score, presence of AF and anticoagulation use, along with end-stage renal failure and smoking were all independently associated with mortality with HRs (95% CIs) of 1.23 (1.21 to 1.25), 1.18 (1.10 to 1.27) and 1.50 (1.40 to 1.60), respectively. Higher CHA2DS2-VASc score was incrementally associated with worse survival both in patients with and without AF (log-rank p<0.001). Anticoagulation use was associated with reduced survival in non-AF patients with alternative anticoagulation indications at all CHA2DS2-VASc score categories, and AF patients with lower CHA2DS2-VASc score 0–2, but was protective in AF patients with higher CHA2DS2-VASc score 4–9.ConclusionIncrementally higher CHA2DS2-VASc score, a simple clinical tool, is associated with mortality in patients regardless of presence of AF and anticoagulation status. Anticoagulation use was associated with worse survival in non-AF patients and AF patients with low CHA2DS2-VASc scores, but was protective in AF patients with high CHA2DS2-VASc scores.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

CHA₂DS₂-VASc score stratifies mortality risk in patients with and without atrial fibrillation

et al. 2021

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“…Notably, several studies [ 11 – 25 ] have investigated the predictive value of CHA 2 DS 2 -VASc score for clinical outcomes beyond stroke, such as death, heart failure hospitalizations and cardiac hospitalizations, in various cardiovascular and non-cardiovascular diseases. In particular, CHA 2 DS 2 -VASc score has been strongly associated with major adverse cardiac outcomes in non-AF community populations [ 11 ] and in following categories of non-AF patients: patients discharged after an acute coronary syndrome and/or acute myocardial infarction [ 12 – 14 ]; patients who underwent cardiac surgery [ 15 ]; HF patients [ 16 – 18 ]; patients with arterial hypertension [ 19 ]; patients with peripheral artery disease [ 20 ]; ambulatory patients [ 21 , 22 ]; finally patients with COPD [ 23 , 24 ] and SARS-CoV-2 [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

CHA2DS2-VASc score stratifies mortality risk in heart failure patients aged 75 years and older with and without atrial fibrillation

et al. 2022

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Background During the last decade, the CHA 2 DS 2 -VASc score has been associated with adverse clinical outcomes in several cardiovascular (CV) and non-cardiovascular diseases beyond atrial fibrillation (AF). Whether the CHA 2 DS 2 -VASc score stratifies mortality risk in elderly patients with AF and without AF is not well established. Methods All consecutive patients aged ≥ 75 yrs hospitalized due to heart failure (HF), between January 2020 and November 2020, were retrospectively enrolled. All patients underwent physical examination, blood tests, electrocardiography and conventional transthoracic echocardiography. Primary endpoint was all-cause mortality, while secondary endpoint was the composite of all-cause mortality + rehospitalizations for all causes over mid-term follow-up. Results The study included 261 HF patients (86.3 ± 6.4 years, 60.5% females). 85 AF and 176 non-AF patients were separately analyzed. Compared to non-AF patients, those with AF had significantly higher CHA 2 DS 2 -VASc score (5.6 ± 1.4 vs 5.1 ± 1.4, p = 0.007) and lower ejection fraction (47.4 ± 16.5 vs 56.7 ± 15.1%, p < 0.001). Mean follow-up was 1.7 ± 0.5 yrs. During follow-up, 96 patients died (58.3% due to CV causes) and 79 were rehospitalized (58.2% due to CV causes). CHA 2 DS 2 -VASc score was independently associated with all-cause mortality in whole study population (HR 1.61, 95% CI 1.36–1.92) and in both AF (HR 1.41, 95% CI 1.09–1.82) and non-AF patients (HR 1.84, 95% CI 1.40–2.40). CHA 2 DS 2 -VASc score also predicted the secondary endpoint in the same study groups. CHA 2 DS 2 -VASc score ≥ 5 was the best cut-off value for predicting both outcomes. Conclusion At mid-term follow-up, a CHA 2 DS 2 -VASc score ≥ 5 predicts increased risk of all-cause mortality and re-hospitalizations for all causes in elderly HF patients, regardless of AF.

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“…This score, developed by Lip GY et al [ 25 ] in 2010, is actually recommended for estimating thromboembolic risk and deciding on anticoagulation therapy in atrial fibrillation (AF) patients [ 26 , 27 ]. In the last few years, the incremental prognostic role of CHA 2 DS 2 -VASc score has been demonstrated in several cardiovascular [ 28 – 33 ] and non-cardiovascular diseases [ 34 , 35 ], irrespective of AF presence.…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of CHA2DS2-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation

Sonaglioni

Caminati

et al. 2023

Intern Emerg Med

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During the last decade, the CHA 2 DS 2 -VASc score has been used for stratifying the mortality risk in both atrial fibrillation (AF) and non-AF patients. However, no previous study considered this score as a prognostic indicator in non-AF patients with mild-to-moderate idiopathic pulmonary fibrosis (IPF). All consecutive non-AF patients with mild-to-moderate IPF, diagnosed between January 2016 and December 2018 at our Institution, entered this study. All patients underwent physical examination, blood tests, spirometry, high-resolution computed tomography and transthoracic echocardiography. CHA 2 DS 2 -VASc score, Gender-Age-Physiology (GAP) index and Charlson Comorbidity Index (CCI) were determined in all patients. Primary endpoint was all-cause mortality, while the secondary endpoint was the composite of all-cause mortality and rehospitalizations for all causes over mid-term follow-up. 103 consecutive IPF patients (70.7 ± 7.3 yrs, 79.6% males) were retrospectively analyzed. At the basal evaluation, CHA 2 DS 2 -VASc score, GAP index and CCI were 3.7 ± 1.6, 3.6 ± 1.2 and 5.5 ± 2.3, respectively. Mean follow-up was 3.5 ± 1.3 yrs. During the follow-up period, 29 patients died and 43 were re-hospitalized (44.2% due to cardiopulmonary causes). On multivariate Cox regression analysis, CHA 2 DS 2 -VASc score (HR 2.15, 95% CI 1.59–2.91) and left ventricular ejection fraction (LVEF) (HR 0.91, 95% CI 0.86–0.97) were independently associated with all-cause mortality in IPF patients. CHA 2 DS 2 -VASc score (HR 1.66, 95% CI 1.39–1.99) and LVEF (HR 0.94, 95% CI 0.90–0.98) also predicted the secondary endpoint in the same study group. CHA 2 DS 2 -VASc score > 4 was the optimal cut-off for predicting both outcomes. At mid-term follow-up, a CHA 2 DS 2 -VASc score > 4 predicts an increased risk of all-cause mortality and rehospitalizations for all causes in non-AF patients with mild-to-moderate IPF.

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

Cited by 7 publications

References 21 publications

CHA₂DS₂-VASc score stratifies mortality risk in patients with and without atrial fibrillation

CHA₂DS₂-VASc score stratifies mortality risk in patients with and without atrial fibrillation

CHA2DS2-VASc score stratifies mortality risk in heart failure patients aged 75 years and older with and without atrial fibrillation

Prognostic role of CHA2DS2-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation

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

Cited by 7 publications

References 21 publications

CHA2DS2-VASc score stratifies mortality risk in patients with and without atrial fibrillation

CHA2DS2-VASc score stratifies mortality risk in patients with and without atrial fibrillation

CHA2DS2-VASc score stratifies mortality risk in heart failure patients aged 75 years and older with and without atrial fibrillation

Prognostic role of CHA2DS2-VASc score for mortality risk assessment in non-advanced idiopathic pulmonary fibrosis: a preliminary observation

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Resources

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CHA₂DS₂-VASc score stratifies mortality risk in patients with and without atrial fibrillation

CHA₂DS₂-VASc score stratifies mortality risk in patients with and without atrial fibrillation