Lin Tzu-Chieh, Su Ho-Ming, Lee Wen-Hsien, Chiu Cheng-An, Chi Nai-Yu, Tsai Wei-Chung, Lin Tsung-Hsien, Voon Wen-Chol, Lai Wen-Ter, Sheu Sheng-Hsiung, Hsu Po-Chao
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University.
Faculty of Medicine, College of Medicine, Kaohsiung Medical University.
Acta Cardiol Sin. 2021 May;37(3):261-268. doi: 10.6515/ACS.202105_37(3).20201021A.
CHADS-VASc score is a useful score to evaluate the risk of stroke in patients with atrial fibrillation (AF), and it has been shown to outperform CHADS score. Our recent cross-sectional study showed that CHADS-VASc score was associated with an ankle-brachial index < 0.9. The aim of the current study was to evaluate whether CHADS-VASc score is a useful predictor of new-onset peripheral artery occlusive disease (PAOD) and whether it can outperform CHADS and RCHADS scores.
We used the National Health Insurance Research Database to survey 723750 patients from January 1, 2000 to December 31, 2001. CHADS, RCHADS, and CHADS-VASc scores were calculated for every patient. Finally, 280176 (score 0), 307209 (score 1), 61093 (score 2), 35594 (score 3), 18956 (score 4), 11032 (score 5), 6006 (score 6), 2696 (score 7), 843 (score 8), and 145 (score 9) patients were studied and followed to evaluate new-onset PAOD. We further divided the study patients into six groups: group 1 (score 0), group 2 (score 1-2), group 3 (score 3-4), group 4 (score 5-6), group 5 (score 7-8), and group 6 (score 9).
Overall, 24775 (3.4%) patients experienced new-onset PAOD during 9.8 years of follow-up. The occurrence rate of PAOD increased from 1.3% (group 1) to 23.4% (group 6). Subgroup analysis by gender also showed an association between CHADS-VASc score and the occurrence rate of PAOD. After multivariate analysis, groups 2-6 were significantly associated with new-onset PAOD. CHADS-VASc score also outperformed CHADS and RCHADS scores for predicting new-onset PAOD.
CHADS-VASc score was a more powerful predictor of new-onset PAOD than CHADS and RCHADS scores in patients without AF.
CHADS-VASc评分是评估心房颤动（AF）患者卒中风险的有用评分，且已证明其优于CHADS评分。我们最近的横断面研究表明，CHADS-VASc评分与踝臂指数<0.9相关。本研究的目的是评估CHADS-VASc评分是否是新发外周动脉闭塞性疾病（PAOD）的有用预测指标，以及它是否优于CHADS和RCHADS评分。
我们使用国民健康保险研究数据库，对2000年1月1日至2001年12月31日期间的723750例患者进行调查。为每位患者计算CHADS、RCHADS和CHADS-VASc评分。最后，对280176例（评分为0）、307209例（评分为1）、61093例（评分为2）、35594例（评分为3）、18956例（评分为4）、11032例（评分为5）、6006例（评分为6）、2696例（评分为7）、843例（评分为8）和145例（评分为9）患者进行研究并随访，以评估新发PAOD。我们进一步将研究患者分为六组：第1组（评分为0）、第2组（评分为1 - 2）、第3组（评分为3 - 4）、第4组（评分为5 - 6）、第5组（评分为7 - 8）和第6组（评分为9）。
总体而言，在9.8年的随访期间，24775例（3.4%）患者发生了新发PAOD。PAOD的发生率从1.3%（第1组）增加到23.4%（第6组）。按性别进行的亚组分析也显示CHADS-VASc评分与PAOD的发生率之间存在关联。多因素分析后，第2 - 6组与新发PAOD显著相关。在预测新发PAOD方面，CHADS-VASc评分也优于CHADS和RCHADS评分。
在无AF的患者中，CHADS-VASc评分对新发PAOD的预测能力比CHADS和RCHADS评分更强。
