R2CHA2DS2-VA Predictsthe Cardiovascular Risk after Carotid Endarterectomy

Ann Vasc Surg. 2023 Aug:94:205-212. doi: 10.1016/j.avsg.2023.02.016. Epub 2023 Mar 2.

Abstract

Background: R2CHA2DS2-VA score has been used to predict short and long-term outcomes in many cardiovascular diseases. This study aims to validate the R2CHA2DS2-VA score as a long-term major adverse cardiovascular events (MACE) predictor after carotid endarterectomy (CEA). Secondary outcomes were also assessed regarding the incidence of all-cause mortality, acute myocardial infarction (AMI), major adverse limb events (MALE), and acute heart failure (AHF).

Methods: From January 2012 to December 2021, patients (n = 205) from a Portuguese tertiary care and referral center that underwent CEA with regional anesthesia (RA) for carotid stenosis (CS) were selected from a previously collected prospective database, and a posthoc analysis was performed. Demographics and comorbidities were registered. Clinical adverse events were assessed 30 days after the procedure and in the subsequent long-term surveillance period. Statistical analysis was performed by the Kaplan-Meier method and Cox proportional hazards regression.

Results: Of the patients enrolled, 78.5% were males with a mean age of 70.44 ± 8.9 years. Higher scores of R2CHA2DS2-VA were associated with long-term MACE (adjusted hazard ratio (aHR) 1.390; 95% confidence interval (CI) 1.173-1.647); and mortality (aHR 1.295; 95% CI 1.08-1.545).

Conclusions: This study demonstrated the potential of the R2CHA2DS2-VA score to predict long-term outcomes, such as AMI, AHF, MACE, and all-cause mortality, in a population of patients submitted to carotid endarterectomy.

MeSH terms

  • Aged
  • Cardiovascular Diseases* / etiology
  • Carotid Stenosis* / complications
  • Carotid Stenosis* / diagnostic imaging
  • Carotid Stenosis* / surgery
  • Endarterectomy, Carotid* / adverse effects
  • Female
  • Heart Disease Risk Factors
  • Heart Failure* / etiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction* / etiology
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke* / etiology
  • Treatment Outcome