CHA2DS2-VASc score in the prediction of ischemic bowel disease among patients with atrial fibrillation: Insights from a nationwide cohort

Abstract

Purpose: This study aimed to evaluate the predictive role of CHA₂DS₂-VASc score specifically for the development of ischemic bowel disease (IBD) among atrial fibrillation (AF) patients.

Methods: Using a nationwide dataset, an AF cohort was established. The study participants were followed up from the index date until they withdrew from the health insurance system, the occurrence of IBD or until the end of 2011. The hazard ratios (HRs) and 95% confidence intervals (CIs) were examined by Cox models to present the subsequent risk of IBD among AF patients by CHA₂DS₂-VASc score. The area under the receiver operating characteristic (ROC) curve was used to assess the predictive power of CHA₂DS₂-VASc score for IBD development among AF patients.

Results: The cumulative incidence of IBD was higher for AF patients with a CHA₂DS₂-VASc score≥2 than those with a CHA₂DS₂-VASc score<2 by 2.30% (p<0.001) at the end of follow-up. After adjustment for hyperlipidemia, chronic obstructive pulmonary disease, and chronic kidney disease, the AF patients with a CHA₂DS₂-VASc score≥2 had a 3.35 times higher risk for IBD development compared to those with a CHA₂DS₂-VASc score<2 [adjusted HR (aHR)=3.35, 95% CI=2.71-4.13]. Among AF patients, the C-statistic of the CHA₂DS₂-VASc score as a predictor of IBD was 0.56 (95% CI=0.55-0.57).

Conclusions: In conclusion, the study is​ the first to investigate the predictive role of CHA₂DS₂-VASc score specifically for IBD development among AF patients. However, the predictive power was relatively low; further studies are necessary to confirm our findings.

Keywords: Atrial fibrillation; CHA(2)DS(2)-VASc score; Cohort; Ischemic bowel disease.