CHADS2 Scores as a Predictor of Ischemic Stroke in Patients With Peripheral Artery Disease

Abstract Objective To assess the predictive value of CHADS 2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke) scores for stroke risk in patients with peripheral artery disease (PAD). Patients and Methods From Taiwan's National Health Insurance Research Database, we identified a total of 479 participants with non–atrial fibrillation PAD diagnoses recorded from January 1, 2002, through December 31, 2009. The CHADS 2 score was used to stratify 5-year ischemic stroke risk. All participants were followed up from the date of enrollment until ischemic stroke event, death, or the end of 2009. Results The 5-year risk of ischemic stroke in the present study was 9.4%. A strong correlation was found between the PAD and CHADS 2 score (CHADS 2 score of 0-1, 0.4%; CHADS 2 score of 2-3, 12.3%; CHADS 2 score ≥4, 84.0%; area under the curve = 0.920). After adjustment, CHADS 2 score was found to be positively correlated with increased risk of ischemic stroke. Conclusions Our results indicate that patients with PAD have a significantly higher risk of ischemic stroke and that the CHADS 2 score can be used as an indicator of risk for ischemic stroke. Cardiovascular risk evaluation and management are suggested for patients with PAD and higher CHADS 2 scores.