Key result
A high CHA2DS2-VASc score (>4) was an independent predictor of concurrent critical coronary artery disease in patients with severe carotid artery stenosis (OR 4.283; 95% CI 2.903-6.321; P<0.001).
Why the study?
Identifying multifocal arterial disease is complex, and the utility of the CHA2DS2-VASc score to assess concomitant CAD in patients scheduled for carotid stenting without prior CAD history was unknown.
Does the CHA2DS2-VASc score predict concurrent critical coronary artery disease in patients with severe carotid artery disease without a prior history of CAD?
Cross-Sectional (n=452)
Does the CHA2DS2-VASc score predict concurrent critical coronary artery disease in patients with severe carotid artery disease without a prior history of CAD?
A CHA2DS2-VASc score >4 is a useful clinical tool to predict the presence of concurrent critical coronary artery disease in patients with severe carotid artery stenosis.
May aid CAD risk stratification in severe carotid stenosis; hypothesis-generating and should not yet change practice.
BACKGROUND: There is a significant correlation between the severity of atherosclerosis in one arterial region and the occurrence of atherosclerotic disease in other regions. Identifying and managing vascular disease in patients with multifocal arterial disease is often complex. The CHA2DS2-VASc score encompasses several cardiovascular risk factors and was initially used to assess the risk of thromboembolism, stroke, and death in patients with atrial fibrillation. In recent years, this score has been proposed to predict the prognosis of various cardiovascular diseases. AIM: The study aimed to investigate the prevalence of concomitant coronary artery disease (CAD) and the correlation between the CHA2DS2-VASc score and CAD in patients who were scheduled for carotid stenting due to carotid artery stenosis (CAS) but had no history of CAD. METHODS: A total of 452 patients were included in the study, 213 with symptomatic CAS and 239 with asymptomatic CAS. The patients were separated into two groups: those with and without. RESULTS: One hundred forty-eight (32.7%) of 452 patients had critical CAD. Multivariate logistic regression analysis showed that a high CHA2DS2-VASc score (OR: 4.283, 95% CI: 2.903-6.321, P < 0.001) was an independent predictor of the development of CAD. Receiver operating characteristic curve (ROC) analysis showed 64.9% sensitivity and 82% specificity in detecting CAD of the CHA2DS2-VASc score at >4 cutoff [Area under ROC curve = 0.781 (95% CI: 0.724-0.838), P < 0.001]. CONCLUSION: When our results were analyzed, a CHA2DS2-VASc score of >4 was highly significant in predicting severe CAD.
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Baran et al. (2025) conducted a cross-sectional in Severe carotid artery disease (n=452). High CHA2DS2-VASc score vs. Low CHA2DS2-VASc score was evaluated on Concurrent critical coronary artery disease (CAD) (OR 4.283, 95% CI 2.903-6.321, p=< 0.001). A high CHA2DS2-VASc score (>4) was an independent predictor of concurrent critical coronary artery disease in patients with severe carotid artery stenosis (OR 4.283; 95% CI 2.903-6.321; P<0.001).
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