Cardiovascular Events and Mortality in Patients on Hemodialysis – the Prognostic Value of the CHA2DS2-VASc Score

Theodoros Tourountzis; Georgios Lioulios; Fotini Stasini; Zoi Skarlatou; Stamatia Stai; Michalis Christodoulou; Eleni Moysidou; Evdoxia Ginikopoulou; Maria Stangou

doi:10.20944/preprints202312.0793.v1

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preprints.org > medicine and pharmacology > urology and nephrology > doi: 10.20944/preprints202312.0793.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Cardiovascular Events and Mortality in Patients on Hemodialysis – the Prognostic Value of the CHA₂DS₂-VASc Score

Theodoros Tourountzis

Michalis Christodoulou

Eleni Moysidou

Evdoxia Ginikopoulou

Maria Stangou

Version 1 : Received: 11 December 2023 / Approved: 12 December 2023 / Online: 12 December 2023 (07:07:45 CET)

A peer-reviewed article of this Preprint also exists.

Tourountzis, T.; Lioulios, G.; Stasini, F.; Skarlatou, Z.; Stai, S.; Christodoulou, M.; Moysidou, E.; Ginikopoulou, E.; Stangou, M. Cardiovascular Events and Mortality in Patients on Hemodialysis: The Prognostic Value of the CHA₂DS₂-VASc Score. Medicina 2024, 60, 144. Tourountzis, T.; Lioulios, G.; Stasini, F.; Skarlatou, Z.; Stai, S.; Christodoulou, M.; Moysidou, E.; Ginikopoulou, E.; Stangou, M. Cardiovascular Events and Mortality in Patients on Hemodialysis: The Prognostic Value of the CHA2DS2-VASc Score. Medicina 2024, 60, 144.

Abstract

Background and Objectives: Cardiovascular events are the leading cause of morbidity and mortal-ity in hemodialysis (HD) patients. Identifying risk factors can help in the effort to reduce cardi-ovascular risk and improve life expectancy. The purpose of this study was to evaluate the ability of CHA2DS2-VASc score [risk index of stroke in atrial fibrillation (AF)] in patients with end stage kidney disease, to predict stroke, major cardiovascular events and mortality. Materials and Meth-ods: CHA2DS2-VASc and HAS-BLED (bleeding risk from use of anticoagulation in AF) scores were calculated in 237 HD patients, [99 women, median age 76 (15) years], at time they com-menced on HD. The scores’ ability to predict long term cardiovascular morbidity and mortality was estimated, both in those with and without AF. Results: CHA2DS2-VASc score was signifi-cantly increased in AF (n=69) compared to non-AF (n=168) patients, 5 (2.5) versus 4 (2), p<0.0001, respectively. Increased CHA2DS2-VASc score was associated with heart failure (p=0.007, p=0.024), stroke (p<0.0001, p<0.0001) and risk of all-cause mortality (p<0.0001, p<0.0001), in both groups, respectively. C statistics indicated that CHA2DS2-VASc score performed modest discrimination in this HD population with and without AF for heart failure, stroke, and all-cause mortality, but for cardiovascular mortality in AF group only. Conclusions: Increased CHA2DS2-VASc score at time starting on HD, can predict stroke, heart failure and all-cause mortality in HD patients in-dependent of the presence of AF. Risk of cardiovascular mortality could be predicted only on patients with AF.

Keywords

stroke; atrial fibrillation; hemodialysis; CHA₂DS₂-VASc score

Subject

Medicine and Pharmacology, Urology and Nephrology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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