CHA2DS2-VASc Score and Risk of New-Onset Peripheral Arterial Occlusive Disease in Patients without Atrial Fibrillation

Background: CHA(2)DS(2)-VASc score is a useful score to evaluate the risk of stroke in patients with atrial fibrillation (AF), and it has been shown to outperform CHADS(2) score. Our recent cross-sectional study showed that CHA(2)DS(2)-VASc score was associated with an ankle-brachial index < 0.9. The aim of the current study was to evaluate whether CHA(2)DS(2)-VASc score is a useful predictor of new-onset peripheral artery occlusive disease (PAOD) and whether it can outperform CHADS(2) and R(2)CHADS(2) scores. Methods: We used the National Health Insurance Research Database to survey 723750 patients from January 1, 2000 to December 31, 2001. CHADS(2), R(2)CHADS(2), and CHA(2)DS(2)-VASc scores were calculated for every patient. Finally, 280176 (score 0), 307209 (score 1), 61093 (score 2), 35594 (score 3), 18956 (score 4), 11032 (score 5), 6006 (score 6), 2696 (score 7), 843 (score 8), and 145 (score 9) patients were studied and followed to evaluate new-onset PAOD. We further divided the study patients into six groups: group 1 (score 0), group 2 (score 1-2), group 3 (score 3-4), group 4 (score 5-6), group 5 (score 7-8), and group 6 (score 9). Results: Overall, 24775 (3.4%) patients experienced new-onset PAOD during 9.8 years of follow-up. The occurrence rate of PAOD increased from 1.3% (group 1) to 23.4% (group 6). Subgroup analysis by gender also showed an association between CHA(2)DS(2)-VASc score and the occurrence rate of PAOD. After multivariate analysis, groups 2-6 were significantly associated with new-onset PAOD. CHA(2)DS(2)-VASc score also outperformed CHADS(2) and R(2)CHADS(2) scores for predicting new-onset PAOD. Conclusions: CHA(2)DS(2)-VASc score was a more powerful predictor of new-onset PAOD than CHADS(2) and R(2)CHADS(2) scores in patients without AF.