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Usefulness of CHA 2 DS 2 ‐VASc score to predict mortality and hospitalization in patients with inflammatory arthritis
Author(s) -
Cioffi Giovanni,
Viapiana Ombretta,
Orsolini Giovanni,
Idolazzi Luca,
Fracassi Elena,
Ognibeni Federica,
Dalbeni Andrea,
Gatti Davide,
Carletto Antonio,
Fassio Angelo,
Rossini Maurizio,
Giollo Alessandro
Publication year - 2020
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13751
Subject(s) - medicine , atrial fibrillation , rheumatoid arthritis , sinus rhythm , psoriatic arthritis , clinical endpoint , heart failure , ankylosing spondylitis , cardiology , proportional hazards model , diabetes mellitus , stroke (engine) , mechanical engineering , engineering , endocrinology , clinical trial
Background Inflammatory arthritis including rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are disorders at increased risk of morbidity and mortality for which a validated prognostic tool for facilitating clinical management is needed. CHA 2 DS 2 ‐VASc (congestive heart failure/hypertension/age diabetes/stroke/vascular disease/age/sex category) score was initially conceived and used to estimate thromboembolic risk in non‐valvular atrial fibrillation, and then successfully applied in community populations with sinus rhythm. We tested CHA 2 DS 2 ‐VASc‐score as a prognosticator of adverse outcomes in patients in sinus rhythm with RA/AS/PsA. Methods Between March 2014 and March 2015, 414 patients (214 RA, 75 AS, 125 PsA) in sinus rhythm without cardiac disease were consecutively analyzed and prospectively followed‐up. Primary and co‐primary end‐points were a composite of all‐cause death/all‐cause hospitalization and CV death/CV hospitalization, respectively. Results Patients were divided into LOWscore and HIGHscore groups if CHA 2 DS 2 ‐VASc was = 0/1 point or greater than 1 point, respectively. The HIGHscore group comprised 190 patients who were older with higher prevalence of CV risk factors and arthritis disease activity than 224 LOWscore patients. During a follow up of 36 months, the event rate for primary and co‐primary end‐point was 37% and 12% in the HIGHscore vs 22% and 4% in LOWscore group ( P = .001 and .002 respectively). At multivariate Cox regression analysis CHA 2 DS 2 ‐VASc‐score was related to primary end‐point (hazards ratio [HR] 1.30 [1.07‐1.59], P = .009) and co‐primary end‐point (HR 1.35 [1.01‐1.79], P = .04) independently of traditional CV risk factors analyzed individually and indexes of inflammation or disease duration. Conclusion CHA 2 DS 2 ‐VASc‐score accurately identifies in the mid‐term patients in sinus rhythm with RA/AS/PsA at different risks for CV and non‐CV mortality and hospitalization.