Key result
Each two-point increment in the CHADS2 score was associated with a 2.51-fold increased risk of new-onset peripheral arterial occlusive disease in patients without atrial fibrillation.
Why the study?
Does the CHADS2 score predict new-onset peripheral arterial occlusive disease in patients without atrial fibrillation?
Cohort (n=723,750)
Does the CHADS2 score predict new-onset peripheral arterial occlusive disease in patients without atrial fibrillation?
Hazard Ratio: 2.51 (95% CI 2.38–2.65)
p-value: p=<0.001
The CHADS2 score, traditionally used to assess stroke risk in atrial fibrillation, is a strong independent predictor of new-onset peripheral arterial occlusive disease in patients without atrial fibrillation.
May support CHADS2 for peripheral arterial disease risk stratification beyond atrial fibrillation; leaves open prospective validation and intervention trials.
AIM: Although our recent cross-sectional study demonstrated that the CHADS2 score is associated with an ankle-brachial index of ＜ 0.9 in patients without atrial fibrillation (AF), the true cause-effect relationship between these parameters remains to be evaluated. Hence, the aim of this study was to investigate whether the CHADS2 score is a useful predictor of new-onset PAOD in non-AF patients. METHODS: From January 1, 2000 to December 31, 2001, a total of 723,750 patients older than 18 years of age with no past history of PAOD, rheumatic heart disease or AF were surveyed from the "National Health Insurance Research Database." The CHADS2 score was calculated for each patient. Finally, 581,997 (score 0), 84,971 (score 1), 31,473 (score 2), 14,432 (score 3), 8,156 (score 4), 2,430 (score 5) and 291 (score 6) patients were studied and followed for the onset of PAOD. We further divided the study patients into four groups: group 1 (score 0), group 2 (score 1-2), group 3 (score 3-4) and group 4 (score 5-6). RESULTS: During the follow-up period of 9.83 ± 0.01 years, 24,775 (3.4%) patients experienced new-onset PAOD. The overall incidence of PAOD was 0.6 per 1,000 patient-years. The rate of PAOD increased from 1.8% (group 1) to 18.7% (group 4) (p ＜ 0.001). According to a multivariate analysis, groups 2-4 were significantly associated with new-onset PAOD (all p ＜ 0.001). In addition, the hazard ratio of each two-point increment in the CHADS2 score for predicting PAOD was 2.51 (p ＜ 0.001). CONCLUSIONS: The CHADS2 score is a useful predictor of new-onset PAOD in non-AF patients.
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Hsu et al. (2014) conducted a cohort in Patients without Atrial Fibrillation (n=723,750). CHADS2 score vs. Lower CHADS2 score was evaluated on New-onset peripheral arterial occlusive disease (PAOD) (HR 2.51, 95% CI 2.38-2.65, p=<0.001). Each two-point increment in the CHADS2 score was associated with a 2.51-fold increased risk of new-onset peripheral arterial occlusive disease in patients without atrial fibrillation.
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