Use of the CHA2 DS2 ‑VASc Score to Predict Concurrent Critical Coronary Artery Stenosis in Patients with Severe Carotid Artery Disease

Abstract

Background: There is a significant correlation between the severity of atherosclerosis in one arterial region and the occurrence of  atherosclerotic disease in other regions. Identifying and managing vascular disease in patients with multifocal arterial disease is often  complex. The CHA2 DS2 -VASc score encompasses several cardiovascular risk factors and was initially used to assess the risk of  thromboembolism, stroke, and death in patients with atrial fibrillation. In recent years, this score has been proposed to predict the  prognosis of various cardiovascular diseases. Aim: The study aimed to investigate the prevalence of concomitant coronary artery disease  (CAD) and the correlation between the CHA2 DS2 -VASc score and CAD in patients who were scheduled for carotid stenting due to carotid  artery stenosis (CAS) but had no history of CAD. Methods: A total of 452 patients were included in the study, 213 with symptomatic CAS  and 239 with asymptomatic CAS. The patients were separated into two groups: those with and without. Results: One hundred forty-eight  (32.7%) of 452 patients had critical CAD. Multivariate logistic regression analysis showed that a high CHA2 DS2 -VASc score (OR: 4.283, 95%  CI: 2.903–6.321, P < 0.001) was an independent predictor of the development of CAD. Receiver operating characteristic curve (ROC)  analysis showed 64.9% sensitivity and 82% specificity in detecting CAD of the CHA2 DS2 ‑VASc score at >4 cutoff [Area under ROC curve =  0.781 (95% CI: 0.724–0.838), P < 0.001]. Conclusion: When our results were analyzed, a CHA2 DS2 ‑VASc score of >4 was highly significant in  predicting severe CAD.