The Association of CHA2DS2-VASc and CHA2DS2-VA Scores with Aortic Arch Calcification and Its Clinical Value in Individuals with Atrial Fibrillation

Recent studies have made recommendations to enhance the relevance and accuracy of this scoring system.According to one study, adding creatinine clearance to mortality prediction data produced more reliable results, especially for those with low creatinine clearance (4).In addition, versions that modify the effectiveness of age have also been previously studied ( 5).In another study, the gender component score was reversed and it was suggested that the CHA 2 DS 2 -VASc score may be predictive as a mortality predictor during the pandemic period (6).Aortic arch calcification (AAC) is a clinically significant characteristic in thrombotic events and has been linked to classic cardiovascular risk factors (7-9).Specifically, there are statistically significant correlations between the severity of cardiovascular illnesses and the degree of AAC ABSTRACTIntroduction: This study investigates the relationship between aortic arch calcification (AAC) and the stroke risk scores, CHA 2 DS 2 -VASc and CHA 2 DS 2 -VA, in patients with atrial fibrillation (AF).It aims to evaluate the association between AAC and these scores and to assess its potential as a marker for cardiovascular risk stratification.Methods: This cross-sectional study included 492 participants stratified by AAC severity (Grades 0-3) based on standard chest X-rays.Stroke risk scores were calculated based on clinical data.Additional parameters, including renal function, inflammatory markers, and medication use, were recorded.Statistical analyses included univariate and multivariate regression analyses, as well as receiver operating characteristic (ROC) curve analysis, to evaluate the predictive value of stroke risk scores for AAC severity.Results: Patients with higher AAC grades demonstrated significantly elevated CHA 2 DS 2 -VASc and CHA 2 DS 2 -VA scores (p<0.001).AAC severity correlated with advanced age, reduced glomerular filtration rate (GFR), lower serum albumin, and anemia.Logistic regression also identified GFR, beyond the stroke risk scores, as an independent predictor of AAC severity.ROC analysis demonstrated that CHA 2 DS 2 -VASc [area under the curve (AUC): 0.694] and CHA 2 DS 2 -VA (AUC: 0.688) scores significantly predicted AAC severity, with optimal cut-off values of >3 and >2, respectively (p<0.001).Conclusion: AAC is significantly associated with higher stroke risk scores in patients with AF, and may serve as an additional tool for risk stratification.Incorporating the AAC assessment into current risk models could provide additional context for cardiovascular risk stratification in patients with AF; however, prospective validation with stroke outcomes is needed.