The Predictive Value of the CHA2DS2-VASc Score in the Development of Contrast-Induced Nephropathy after Endovascular Intervention in Peripheral Artery Disease.

BACKGROUND: Contrast-induced nephropathy (CIN) is a frequent complication of endovascular interventions for peripheral artery disease (PAD). It is linked to renal dysfunction, extended hospital stays, increased cardiovascular events, and higher mortality rates. The CHA2DS2-VASc score, widely utilized for assessing cardioembolic risk and guiding anticoagulation therapy in nonvalvular atrial fibrillation, encompasses risk factors that overlap with those of CIN. This study investigates whether the CHA2DS2-VASc score can predict CIN in PAD patients undergoing endovascular interventions.

METHODS: The study included 754 consecutive PAD patients who underwent endovascular procedures at 2 centers. Each patient's CHA2DS2-VASc score was calculated and categorized into low (<3) and high (≥3) groups. Patients were retrospectively monitored for CIN development and divided into CIN-positive (CIN+) and CIN-negative (CIN-) groups. Univariate and multivariate regression analyses were performed to identify independent predictors of CIN, and a significance level of P < 0.05 was used for all statistical analyses.

RESULTS: Of the 754 patients, 178 (23.6%) developed CIN, with 151 (84.8%) occurring in the high CHA2DS2-VASc score group (P < 0.001). The CHA2DS2-VASc score was significantly higher in the CIN(+) group compared to the CIN(-) group (P < 0.001). Regression analysis identified the CHA2DS2-VASc score (odds ratio [OR]: 1.574, 95% confidence interval [CI]: 1.298-1.907, P < 0.001), baseline creatinine (OR: 2.296, 95% CI: 1.580-3.335, P < 0.001), and hemoglobin (OR: 0.915, 95% CI: 0.844-0.992, P < 0.001) as independent risk factors. A CHA2DS2-VASc score cutoff of 2.5 predicted CIN with 85% sensitivity and 42% specificity.

CONCLUSION: The CHA2DS2-VASc score is an independent predictor of the development of CIN in patients with PAD undergoing endovascular intervention.