Huang Pang-Shuo, Cheng Jen-Fang, Chen Jien-Jiun, Wu Cho-Kai, Wang Yi-Chih, Hwang Juey-Jen, Tsai Chia-Ti
Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taiwan.
Heliyon. 2023 Feb 22;9(3):e13978. doi: 10.1016/j.heliyon.2023.e13978. eCollection 2023 Mar.
End stage renal disease (ESRD) is an increasing worldwide epidemic disease. CHA2DS2-VASc score is a well-established predictor of cardiovascular outcome among atrial fibrillation (AF) patients.
The aim of this study was to test whether CHA2DS2-VASc score is a good predictor for incident ESRD events.
This is a retrospective cohort study (from January 2010 to December 2020) with median follow-up of 61.7 months. Clinical parameters and baseline characteristics were recorded. The endpoint was defined as ESRD with dialysis dependent.
The study cohort comprised 29,341 participants. Their median age was 71.0 years, 43.2% were male, 21.5% had diabetes mellitus, 46.1% had hypertension, and mean CHA2DS2-VASc score was 2.89. CHA2DS2-VASc score was incrementally associated with the risk of ESRD status during follow-up. Using the univariate Cox model, we found a 26% increase in ESRD risk with an increase of one point in the CHA2DS2-VASc score (HR 1.26 [1.23-1.29], P < 0.001). And using the multi-variate Cox model adjusted by initial CKD stage, we still observed a 5.9% increase in risk of ESRD with a one-point increase in the CHA2DS2-VASc score (HR 1.059 [1.037-1.082], P < 0.001). The CHA2DS2-VASC score and the initial stage of CKD were associated with the risk of ESRD development in patients with AF.
Our results first confirmed the utility of CHA2DS2-VASC score in predicting progression to ESRD in AF patients. The efficiency is best in CKD stage 1.
终末期肾病（ESRD）是一种在全球范围内日益流行的疾病。CHA2DS2-VASc评分是心房颤动（AF）患者心血管结局的公认预测指标。
本研究旨在测试CHA2DS2-VASc评分是否是ESRD事件发生的良好预测指标。
这是一项回顾性队列研究（2010年1月至2020年12月），中位随访时间为61.7个月。记录临床参数和基线特征。终点定义为依赖透析的ESRD。
研究队列包括29341名参与者。他们的中位年龄为71.0岁，43.2%为男性，21.5%患有糖尿病，46.1%患有高血压，平均CHA2DS2-VASc评分为2.89。CHA2DS2-VASc评分与随访期间ESRD状态的风险逐渐相关。使用单变量Cox模型，我们发现CHA2DS2-VASc评分每增加1分，ESRD风险增加26%（HR 1.26 [1.23-1.29]，P < 0.001）。并且使用根据初始CKD阶段调整的多变量Cox模型，我们仍然观察到CHA2DS2-VASc评分每增加1分，ESRD风险增加5.9%（HR 1.059 [1.037-1.082]，P < 0.001）。CHA2DS2-VASC评分和CKD的初始阶段与AF患者发生ESRD的风险相关。
我们的结果首次证实了CHA2DS2-VASC评分在预测AF患者进展为ESRD方面的效用。在CKD 1期效率最佳。
