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CHADS2 and CHA2DS2Vasc-Score in Peripheral Systemic Embolism

Objectives: We analysed the characteristics of patients with an acute embolic peripheral event considering the possible use of the CHADS2-Score and the CHA2DS2Vasc-Score

Patients and Methods: We retrospectively analysed 163 cases of acute embolic events in peripheral arteries treated from 2008 to 2011. Peripheral limb embolism was defined by an acute onset of ischemia, sonographic or angiographic imaging and intra-operative findings. In addition, we included some patients with acute embolic events affecting the visceral and renal artery. We retrospectively screened the medical form for information regarding AF, a proven source of the embolus and the risk factors necessary to calculate the CHADS2 and CHA2DS2vasc score.  

Results: Arterial hypertension and age > 75 years were the most frequent risk factors. Mean CHADS2 score was similar in males and females (2.3 ± 1.5 and 2.3 ± 1.4). 66% of the males and 63.3% of the females scored 2 and more points. Mean CHA2DS2Vasc score was 3.6 ± 2.0 in males and 4.6 ± 1.9 in females. 85.2% of the males and 95.4% of the females scored more than 2 points.

In the medical forms AF was documented in 79 (48%) patients, of which 23 (43 %) were males and 56 (51%) females. Mean CHADS2 score and mean CHA2DS2Vasc score were slightly higher in those with AF compared to the total group, but not significantly different. The rate of patients with 2 and more points increased for both scores: CHADS2 score: males 82.6% and females 76.8%, CHA2DS2Vasc: males 100% and females 98.2%. Almost half of the patients with AF had had anticoagulation with phenprocoumon before (males 12 (52%), females 24 (43%), but only every 10th was within the therapeutic range (INR ≥2)

Conclusion: The number of those with AF is high amongst patients with acute embolic events in peripheral arteries. According to the CHADS2 and CHA2DS2Vasc score, most of these patients had an indication for oral anticoagulation. 



Credits: Frans Santosa; Thomas Nowak; Theodoros Moysidis; Frank Eickmeier; Christoph Stallinger; Bernd Luther; Kröger Knut

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