Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia.
Department of Dialysis, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia.
Am J Nephrol. 2021;52(5):404-411. doi: 10.1159/000516121. Epub 2021 May 11.
Chronic kidney disease (CKD) is a risk factor for cardiovascular and all-cause mortality. Recognition of high-risk patients is important and could lead to a different approach and better treatment. The CHA2DS2-VASc score was originally used to predict cerebral infarction in patients with atrial fibrillation (AF), but it is also a useful predictor of outcome in other cardiovascular conditions, independent of AF. Therefore, the aim of our research was to assess the role of CHA2DS2-VASc score in predicting cardiovascular and all-cause mortality in CKD patients.
Stable nondialysis CKD patients were included. At the time of inclusion, medical history data and standard blood results were collected and CHA2DS2-VASc score was calculated. Patients were followed till the same end date, until kidney transplantation or until their death.
Eighty-seven CKD patients were included (60.3 ± 12.8 years, 66% male). Mean follow-up time was 1,696.5 ± 564.6 days. During the follow-up, 21 patients died and 11 because of cardiovascular reasons. Univariate Cox regression analysis showed that CHA2DS2-VASc score is a significant predictor of cardiovascular and all-cause mortality. In multivariate Cox regression analysis, in which CHA2DS2-VASc score, serum creatinine, urinary albumin/creatinine, hemoglobin, high-sensitivity C-reactive protein, and intact parathyroid hormone were included, CHA2DS2-VASc score was an independent predictor of cardiovascular (HR: 2.04, CI: 1.20-3.45, p = 0.008) and all-cause mortality (HR: 2.06, CI: 1.43-2.97, p = 0.001). The same was true after adding total cholesterol, triglycerides, and smoking status to both the analyses.
The CHA2DS2-VASc score is a simple, practical, and quick way to identify the risk for cardiovascular and all-cause mortality in CKD patients.
慢性肾脏病（CKD）是心血管疾病和全因死亡率的危险因素。识别高危患者非常重要，可能会导致采用不同的方法和更好的治疗。CHA2DS2-VASc 评分最初用于预测心房颤动（AF）患者的脑梗死，但它也是其他心血管疾病的预后有用预测指标，与 AF 无关。因此，我们的研究旨在评估 CHA2DS2-VASc 评分在预测 CKD 患者心血管疾病和全因死亡率中的作用。
纳入稳定的非透析 CKD 患者。在纳入时，收集了病史数据和标准血液结果，并计算了 CHA2DS2-VASc 评分。患者随访至相同的截止日期，直至肾移植或死亡。
纳入了 87 例 CKD 患者（60.3±12.8 岁，66%为男性）。平均随访时间为 1696.5±564.6 天。在随访期间，21 例患者死亡，其中 11 例死于心血管原因。单因素 Cox 回归分析显示，CHA2DS2-VASc 评分是心血管和全因死亡率的显著预测因素。在多因素 Cox 回归分析中，纳入了 CHA2DS2-VASc 评分、血清肌酐、尿白蛋白/肌酐、血红蛋白、高敏 C 反应蛋白和完整甲状旁腺激素，CHA2DS2-VASc 评分是心血管（HR：2.04，CI：1.20-3.45，p=0.008）和全因死亡率（HR：2.06，CI：1.43-2.97，p=0.001）的独立预测因素。在将总胆固醇、甘油三酯和吸烟状况添加到这两个分析中后，也是如此。
CHA2DS2-VASc 评分是一种简单、实用、快速的方法，可以识别 CKD 患者心血管疾病和全因死亡率的风险。
