Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Assessing the Suitability of CHA2DS2-VASc for Predicting Adverse Limb Events and Cardiovascular Outcomes in Peripheral Artery Disease Patients

Version 1 : Received: 1 May 2024 / Approved: 2 May 2024 / Online: 2 May 2024 (09:41:19 CEST)

How to cite: Cheng, Y.-T.; Chang, F.-L.; Li, P.-H.; Lu, W.-C.; Chiu, C.-S. Assessing the Suitability of CHA2DS2-VASc for Predicting Adverse Limb Events and Cardiovascular Outcomes in Peripheral Artery Disease Patients. Preprints 2024, 2024050110. https://doi.org/10.20944/preprints202405.0110.v1 Cheng, Y.-T.; Chang, F.-L.; Li, P.-H.; Lu, W.-C.; Chiu, C.-S. Assessing the Suitability of CHA2DS2-VASc for Predicting Adverse Limb Events and Cardiovascular Outcomes in Peripheral Artery Disease Patients. Preprints 2024, 2024050110. https://doi.org/10.20944/preprints202405.0110.v1

Abstract

Patients with Peripheral-artery-disease (PAD) are prone to risks of major-adverse-limb-events (MALE), and major-adverse-cardiovascular-events (MACE). CHA2DS2-VASc is a prognostic score for Atrial fibrillation stroke risk, however, no study exists that evaluated its predictability for MALE and MACE in PAD patients. In this study, patients with PAD were stratified into four risk groups based on CHA2DS2-VASc score. Cox-proportional hazards models,10-fold cross-validation and Receiver operating characteristic (ROC) analyses were utilized to evaluate the predictability of CHA2DS2-VASc for predicting MALE, MACE, and MALE+MACE. Kaplan-Meier analysis estimated the survival-probability of risk-groups. CHA2DS2-VASc was found to be a significant predictor of MACE (hazard ratio (95% confidence interval; P) = 3.47 (0.99 - 12.18; 0.052), 4.12 (1.19 - 14.14; 0.024), and 5.06 (1.48 – 17.28; 0.009), for moderate-, high- and very-high-risk groups, respectively, while for MALE and MALE+MACE significance was achieved only for high-risk group. MACE demonstrated AUC > 0.8, good-discrimination (c-index > 0.8) and good-calibration. However, MALE and MALE+MACE models failed to achieve good performances. Based on all findings, CHA2DS2-VASc could potentially serve as a risk stratification score for predicting MACE in patients with PAD but failed to qualify as a good predictor for MALE.

Keywords

Peripheral artery disease (PAD); modified cumulative risk (MCR) score; CHA2DS2-VASc; Major adverse cardiovascular events (MACE); Major adverse limb events (MALE); percutaneous coronary intervention (PCI)

Subject

Public Health and Healthcare, Other

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