The Relationship Between the CHA₂DS₂-VASc Score and Lesion Complexity and Long-Term Outcomes in Peripheral Arterial Disease

OBJECTIVE
Originally designed to evaluate stroke risk in individuals with atrial fibrillation unrelated to valvular disease, the CHA2DS2-VASc score is now additionally utilized for the prognostic evaluation of cardiovascular diseases. This study aimed to evaluate the predictive role of the CHA₂DS₂-VASc score for lesion severity and long-term survival outcomes in individuals with peripheral artery disease (PAD).

METHODS
This retrospective analysis included 784 patients diagnosed with PAD via CT (computed tomography) angiography, consecutively enrolled from two medical center. The CHA2DS2-VASc score was determined for all participants. Lesion severity was assessed according to the TASC II criteria, and patients were categorized into TASC-AB (simple) and TASC-CD (complex) lesion groups. Mortality data were achieved from hospital and social security records.

RESULTS
The study included 784 patients (average age 61.7±9.9 years; 17.2% female). In the regression analysis performed to predict lesion severity, we found that the CHA2DS2-VASc score (p < 0.007) and left ventricular ejection fraction (p = 0.009) were independent predictors. The ROC curve indicated that a CHA2DS2VASc score threshold of 3.5 predicted long term mortality with 70% sensitivity and 79% specificity (p<0.001). Kaplan–Meier survival estimates indicated that patients with higher CHA₂DS₂-VASc scores had significantly lower survival rates over the 60-month follow-up period (p < 0.001).

CONCLUSION
The CHA₂DS₂-VASc score was independently associated with both lesion severity and adverse long-term outcomes in individuals with PAD.