The following is a summary of “Prognostic value of CHA2DS2-VASc and modified-CHADS2 scores for cardiovascular events in diabetics and non-diabetics hemodialysis patients,” published in the April 2023 issue of Nephrology by Tourountzis, et al.

For a study, researchers sought to evaluate the effectiveness of CHA₂DS₂-VASc and modified-CHADS₂ scores in estimating the risk of stroke in hemodialysis patients and to assess the impact of diabetes mellitus (DM) on these scores.

The study involved 237 hemodialysis patients, including 121 diabetics (58 females) and 116 non-diabetics (41 females). The scores were calculated for each patient, and the results were correlated with cardiovascular events such as acute myocardial infarction, atrial fibrillation, heart failure, peripheral arterial disease, stroke, and mortality.

In both diabetics and non-diabetics, the CHA₂DS₂-VASc score showed a correlation with the occurrence of stroke and heart failure (P < .01, P < .01) and could predict the risk of all-cause mortality (P = .03, P < .01) in both groups. However, the risk of cardiovascular death could only be predicted by the CHA₂DS₂-VASc score in non-diabetics (P < .01). The modified-CHADS₂ score was associated with heart failure (P = .04), cardiovascular mortality (P < .01), and all-cause mortality (P < .01) in non-diabetics only. The C statistics indicated that the CHA₂DS₂-VASc score had modest discrimination for stroke and all-cause mortality in patients with and without DM, while the modified-CHADS₂ score performed modestly only for all-cause mortality in patients without DM. Both scores showed poor calibration. Stroke was found to be a common cause of cardiovascular death (OR = 3.52, 95% CI = 1.92–6.47, P < .01) and was associated with the central venous catheter (OR = 2.19, 95% CI = 1.12–4.27, P = .02) and pre-existing atrial fibrillation (OR = 1.94, 95% CI = 1.06–3.58, P = .03).

The CHA₂DS₂-VASc score correlated with stroke, heart failure, and all-cause mortality in hemodialysis patients with and without DM. The risk of cardiovascular death could only be predicted in non-diabetic patients. The modified-CHADS₂ score correlated with heart failure, cardiovascular mortality, and all-cause mortality in nondiabetic patients. However, both scores demonstrated modest discrimination and poor calibration.

Source: onlinelibrary.wiley.com/doi/10.1111/nep.14165