CHA2DS2-VASc评分与心房颤动患者主动脉钙化的相关性及性别特异性预测价值OA

Background and Aims:Aortic calcification is an important risk factor for adverse cardiovascular outcomes and aortic diseases.However,effective tools for assessing the risk of aortic calcification in patients with atrial fibrillation(AF)remain limited.The CHA2DS2-VASc score is widely used for stroke risk stratification in AF,but its association with aortic calcification has not been fully elucidated.This study aimed to investigate the relationship between the CHA2DS2-VASc score and aortic calcification and to evaluate its predictive value in patients with AF. Methods:A total of 1538 patients with AF who underwent multi-slice computed tomography(MSCT)at the Third Xiangya Hospital,Central South University between February 2015 and February 2022 were retrospectively included.Patients were classified into aortic calcification and non-calcification groups according to MSCT findings.Receiver operating characteristic(ROC)curve analysis was performed to determine the optimal cut-off values of the CHA2DS2-VASc score for predicting aortic calcification.Multivariable logistic regression analysis was used to evaluate the independent association between the CHA2DS2-VASc score and aortic calcification. Results:Aortic calcification was identified in 1251 patients(81.3％).Compared with the non-calcification group,patients with aortic calcification were older and had higher prevalences of hypertension,diabetes mellitus,coronary artery disease,cerebral infarction,and heart failure(all P<0.05).The CHA2DS2-VASc score was significantly higher in the calcification group[3.0(2.0-4.0)vs.1.0(0-2.0),P<0.001].The prevalence of aortic calcification increased progressively with increasing CHA2DS2-VASc scores(P for trend<0.001).ROC analysis demonstrated that the optimal cut-off value was 2 points in men(AUC=0.737,95％CI=0.697-0.776)and 3 points in women(AUC=0.730,95％CI=0.673-0.787).Multivariable logistic regression showed that each 1-point increase in the CHA2DS2-VASc score was independently associated with a higher risk of aortic calcification(OR=1.912,95％CI=1.638-2.232,P<0.001).Male patients with a score≥2 and female patients with a score≥3 had significantly increased risks of aortic calcification[OR=5.528(95％CI=3.240-9.434)and 9.295(95％CI=4.390-19.681),respectively;both P<0.001]. Conclusion:The CHA2DS2-VASc score is significantly associated with the risk of aortic calcification in patients with AF and demonstrates good predictive performance.Sex-specific thresholds of≥2 for men and≥3 for women may facilitate risk stratification and early identification of patients at high risk for aortic calcification.