Key result
A one-point increase in the CHA2DS2-VASc score was associated with a 5.9% increased risk of incident end stage renal disease in patients with atrial fibrillation (HR 1.059; 95% CI 1.037-1.082; P<0.001).
Why the study?
Although the CHA2DS2-VASc score predicts cardiovascular outcomes in AF, its utility for predicting incident ESRD events remained unknown.
Does the CHA2DS2-VASc score predict the risk of incident end-stage renal disease in patients with atrial fibrillation?
Cohort (n=29,341)
Does the CHA2DS2-VASc score predict the risk of incident end-stage renal disease in patients with atrial fibrillation?
Answers are grounded in this paper and cite their sources.
The CHA2DS2-VASc score is an independent predictor of progression to end-stage renal disease in patients with atrial fibrillation, particularly in those with early-stage CKD.
Background: 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. Objective: The aim of this study was to test whether CHA2DS2-VASc score is a good predictor for incident ESRD events. Methods: 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. Results: 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. Conclusions: 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.
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Huang et al. (2023) conducted a cohort in atrial fibrillation (n=29,341). CHA2DS2-VASc score was evaluated on ESRD with dialysis dependent (HR 1.059, 95% CI 1.037-1.082, p=< 0.001). A one-point increase in the CHA2DS2-VASc score was associated with a 5.9% increased risk of incident end stage renal disease in patients with atrial fibrillation (HR 1.059; 95% CI 1.037-1.082; P<0.001).
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