Skip to main content

Association between Rutherford Classification and CHA2DS2-VASc, CHADS2 and ASCVD Scores in Peripheral Artery Disease Patients

Abstract

Background and Aim

The classification system is important in assessing the severity of Peripheral Artery Disease (PAD) and making the treatment decision. However, classification systems may not be sufficient and scoring systems developed to predict cardiovascular and cerebrovascular events can also be useful to assess the severity of PAD. In this study, our aim was to investigate the association of the Rutherford classification and CHADS2, CHA2DS2-VASc and ASCVD scores in PAD patients.

Method

A total of 65 consecutive patients with PAD (males 92.3%, mean age 63.0 ± 9.2 years), who underwent percutaneous peripheral intervention were included in our retrospective study.

Results

There were 16 patients in Category 2, 31 patients in Category 3, and 10 patients in Category 4 and eight patients in Category 5. The CHADS2, CHA2DS2-VASc and ASCVD scores were found to be significantly different among the Rutherford categories and between each other. From Category 1 to 5, CHADS2, CHA2DS2-VASc and ASCVD scores were significantly increased. When we grouped the scores as CHADS2 <2 and ≥2 and CHA2DS2-VASc <4 and ≥4, it was determined that as the category increased the score group also increased. There was significantly correlation between CHADS2, CHA2DS2-VASc and ASCVD scores with the Rutherford categories in correlation analyses.

Conclusion

As far as we know, in this study which is the first study about the association of Rutherford classification and scoring systems, the major finding of the present study is that the CHADS2, CHA2DS2-VASc and ASCVD scores was independently correlated with the severity of Rutherford Category in patients with PAD.

References

  1. Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999–2000. Circulation 2004;110:738–43.

    Google Scholar 

  2. Matsushita K, Ballew SH, Coresh J, Arima H, Ärnlöv J, Cirillo M, et al. Measures of chronic kidney disease and risk of incident peripheral artery disease: a collaborative meta-analysis of individual participant data. Lancet Diabetes Endocrinol 2017;5:718–28.

    Google Scholar 

  3. Hardman RL, Jazaeri O, Yi J, Smith M, Gupta R. Overview of classification systems in peripheral artery disease. Semin Intervent Radiol 2014;31:378–88.

    Google Scholar 

  4. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on Atrial Fibrillation. Chest 2010;137:263–72.

    Google Scholar 

  5. Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129:S49–S73.

    Google Scholar 

  6. Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg 1997;26:517–38.

    Google Scholar 

  7. Crawford F, Welch K, Andras A, Chappell FM. Ankle brachial index for the diagnosis of lower limb peripheral arterial disease. Cochrane Database Syst Rev 2016;9:CD010680.

  8. Bhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL, et al. International prevalence, recognition, and treatment of cardiovascular risk factors in out-patients with atherothrombosis. JAMA 2006;295:180–9.

    Google Scholar 

  9. Criqui MH, Ninomiya JK, Wingard DL, Ji M, Fronek A. Progression of peripheral arterial disease predicts cardiovascular disease morbidity and mortality. J Am Coll Cardiol 2008;52:1736–42.

    Google Scholar 

  10. Cetin M, Cakici M, Zencir C, Tasolar H, Baysal E, Balli M, et al. Prediction of coronary artery disease severity using CHADS2 and CHA2DS2-VASc scores and a newly defined CHA2DS2-VASc-HS score. Am J Cardiol 2014;113:950–6.

  11. Modi R, Patted SV, Halkati PC, Porwal S, Ambar S, Metgudmath V, et al. CHA2DS2-VASc-HSF score – new predictor of severity of coronary artery disease in 2976 patients. Int J Cardiol 2017;228: 1002–6.

  12. Hoshino T, Ishizuka K, Shimizu S, Uchiyama S. CHADS2, CHA2DS2-VASc, and R2CHADS2 scores are associated with 3-month functional outcome of stroke in patients with prior coronary artery disease. Circ J 2014;78:1481–5.

    Google Scholar 

  13. Hsu PC, Lin TH, Lee WH, Chu CY, Chiu CA, Lee HH, et al. Association between the CHADS2 score and an ankle-brachial index of <0.9 in patients without atrial fibrillation. J Atheroscler Thromb 2014;21:322–8.

    Google Scholar 

  14. Hsu PC, Chiu CA, Chu CY, Lee WH, Su HM, Lin TH, et al. CHADS2 score and risk of new-onset peripheral arterial occlusive disease in patients without atrial fibrillation: a nationwide cohort study in Taiwan. J Atheroscler Thromb 2015;22:490–8.

    Google Scholar 

  15. Hsu PC, Lee WH, Lee HC, Tsai WC, Chu CY, Chen YC, et al. Association between modified CHA2DS2-VASc Score with Ankle-Brachial index <0.9. Sci Rep 2018;8:1175.

    Google Scholar 

  16. Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003;24:987–1003.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hüseyin Ayhan.

Additional information

Peer review under responsibility of the Association for Research into Arterial Structure and Physiology

Data availability statement: The data that support the findings of this study are available from the corresponding author (HA), upon reasonable request.

Rights and permissions

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Karaduman, B.D., Ayhan, H., Keles, T. et al. Association between Rutherford Classification and CHA2DS2-VASc, CHADS2 and ASCVD Scores in Peripheral Artery Disease Patients. Artery Res 26, 111–116 (2020). https://doi.org/10.2991/artres.k.200504.001

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2991/artres.k.200504.001

Keywords