Association between the CHADS₂ Score and an Ankle-Brachial Index of ＜0.9 in Patients without Atrial Fibrillation

Abstract

Aim: The ankle-brachial index(ABI) is an easy-to-use, non-invasive and reliable diagnostic tool for assessing peripheral arterial occlusive disease(PAOD). The CHADS₂(congestive heart failure, hypertension, age ≧75 years, diabetes, prior stroke) score is a simple and popular clinical parameter that is used to assess the risk of stroke in patients with atrial fibrillation(AF). Because all five components of the CHADS₂ score are risk factors for PAOD, the score should have a strong correlation with the presence of PAOD. However, there are limited studies regarding the association between the CHADS₂ score and PAOD in patients without AF. Therefore, the aim of the present study was to investigate whether the CHADS₂ score is positively associated with PAOD in patients without AF.
Methods: A total of 1,320 patients without AF were included in this study. The ABI was measured using an ABI-form device. PAOD was defined as an ABI of ＜0.9 in either leg.
Results: Among the 1,320 subjects(mean age: 60.3±13.4 years), the prevalence of an ABI of ＜0.9 was 5.7%. A multivariate analysis showed that an increased age(odds ratio [OR], 1.054; p＜0.001), decreased estimated glomerular filtration rate (OR, 0.971; p＜0.001) and increased CHADS₂ score(OR, 1.861; p＜0.001) were independently associated with an ABI of ＜0.9.
Conclusions: Our study demonstrated that the CHADS₂ score is significantly associated with an ABI of ＜0.9 in non-AF patients. Further prospective studies are needed to examine the ability of the CHADS₂ score to predict the incidence of PAOD.