Association between the CHADS2 Score and an Ankle-Brachial Index of ＜0.9 in Patients without Atrial Fibrillation

Abstract

Aim:The ankle-brachial index (ABI) is an easy-to-use, non-invasive and reliable diagnostic tool for assessing peripheral arterial occlusive disease (PAOD). The CHADS2 (congestive heart failure, hypertension, age ≧75 years, diabetes, prior stroke) score is a simple and popular clinical parameter that is used to assess the risk of stroke in patients with atrial fibrillation (AF). Because all five components of the CHADS2 score are risk factors for PAOD, the score should have a strong correlation with the presence of PAOD. However, there are limited studies regarding the association between the CHADS2 score and PAOD in patients without AF. Therefore, the aim of the present study was to investigate whether the CHADS2 score is positively associated with PAOD in patients without AF. Methods: A total of 1,320 patients without AF were included in this study. The ABI was measured using an ABI-form device. PAOD was defined as an ABI of ＜0.9 in either leg. Results: Among the 1,320 subjects (mean age: 60.3±13.4 years), the prevalence of an ABI of ＜0.9 was 5.7%. A multivariate analysis showed that an increased age (odds ratio [OR], 1.054; p＜0.001), decreased estimated glomerular filtration rate (OR, 0.971; p＜0.001) and increased CHADS2 score (OR, 1.861; p＜0.001) were independently associated with an ABI of ＜0.9. Conclusions: Our study demonstrated that the CHADS2 score is significantly associated with an ABI of ＜0.9 in non-AF patients. Further prospective studies are needed to examine the ability of the CHADS2 score to predict the incidence of PAOD. J Atheroscler Thromb, 2014; 21:322-328.

CHADS₂ Score and Risk of New-onset Peripheral Arterial Occlusive Disease in Patients without Atrial Fibrillation: A Nationwide Cohort Study in Taiwan

“…In addition, Welles et al showed that the score can be used to predict ischemic stroke/transient ischemic accident in non-AF subjects with coronary heart disease 12) , and Chao et al demonstrated that a high CHADS2 score is associated with an increased risk of new-onset AF in non-AF patients 13) . Furthermore, our recent cross-sectional study confirmed a significant association between the CHADS2 score and PAOD, as indicated by an ABI of 0.9, in non-AF patients 14) . In the present study, we further found that a twopoint increment in the CHADS2 score was associated with a 2.51-fold risk of new-onset PAOD in the non-AF patients.…”

“…In addition, several studies have reported that the CHADS2 score can be used to predict subsequent cardiovascular events and new-onset AF in non-AF populations [11][12][13] . As an older age, hypertension, diabetes, congestive heart failure and stroke are all risk factors for PAOD [1][2][3][4][5][6][7] , our recent cross-sectional study demonstrated that the CHADS2 score is significantly associated with an ankle-brachial index (ABI) of 0.9 in non-AF patients 14) . However, divided the study patients into four groups: group 1 (score 0), group 2 (score 1-2), group 3 (score 3-4) and group 4 (score 5-6).…”

The CHADS2 Score to Predict Stroke Risk in the Absence of Atrial Fibrillation in Hypertensive Patients Aged 65 Years or Older

“…In the last few years, use of the CHADS 2 score has extended beyond the original scenario of atrial fibrillation, 14,15 and it has shown certain advantages over other methods (SCORE or Framingham criteria), such as inclusion of older patients and greater ease of use in daily practice. Henriksson et al applied this score to a large series of stroke survivors included in the Swedish Stroke Registry and reported that the risk of death due to a cerebral event at 5 years showed a progressive, linear increase in parallel with the CHADS 2 score, in both patients with atrial fibrillation and those in sinus rhythm.…”

Uso de la escala CHADS2 como predictor de riesgo de mortalidad en pacientes hipertensos. El estudio FAPRES

“…La puntuación CHADS 2 4 se desarrolló originalmente como un esquema de predicción del riesgo de ictus en los pacientes con fibrilación auricular no valvular 1,3 . Sin embargo, en los últimos años se ha extendido su uso más allá de su escenario original de la fibrilación auricular 16,17 , y presenta algunas ventajas sobre otras escalas (SCORE o Framingham), como la inclusión de pacientes de más edad y su menor complejidad en su utilización diaria. Henriksson et al han aplicado esta puntuación a una amplia serie de pacientes supervivientes a un ictus incluidos en el Swedish Stroke Registry, y demuestran que el riesgo de mortalidad a los 5 años del episodio cerebral aumenta gradual y linealmente con la puntación del CHADS 2 , tanto para pacientes con fibrilación auricular como en ritmo sinusal 18 .…”