Understanding Vascular Age: Are Clinical scoring systems useful for Early Vascular Aging Syndrome Prediction ?
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ORIGINAL ARTICLE
Understanding Vascular Age: Are Clinical scoring systems useful for Early Vascular Aging Syndrome Prediction ? Alparslan Kilic1 · Onur Baydar1 · Betul Cengiz Elcioglu1 · Volkan Camkiran1 · Ziya Apaydin2 · Mehmet Mustafa Can2 · Deniz Elcik3 Received: 26 August 2020 / Accepted: 10 October 2020 © Italian Society of Hypertension 2020
Abstract Introduction Early vascular aging syndrome (EVAS) is defined as increased arterial stiffness compared to age and sex matched patients, EVAS is measured by pulse wave velocity (PWV). Aim In our study we aim to identify in patients with high risk of EVAS using the CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HS scores. Methods The CHADS2, CHA2DS2-VASc-HS and CHADS2VASC scoring systems are advised to determine management strategies in patients with nonvalvular atrial fibrillation. As they contain similar risk factors for the development or presence of EVAS, we believed that this risk scoring system could also be used to predict EVAS. This study was designed as a retrospective observational study. 2108 consecutive patients who had undergone 24-h blood pressure monitoring and measured PWV levels were included in the study. The patients were divided into the two groups according to corrected Pwv values. Results CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HS scores were positively correlated with PWV values (r =0.251, p < 0.001; r = 0.457, p < 0.001; and r = 0.385, p < 0.001, respectively). CHA2DS2-VASc-HS score was statistically better than CHA2DS2, CHA2DS2-VASc score to predict early vascular aging syndrome (p < 0.001). For the prediction of EVAS, the cut-off value of CHA2DS2-VASc-HS score was ≥ 1.5 with a sensitivity of 49% and a specificity of 50 % (AUC 0.605; 95% [CI] 0.58–0.63) in the ROC curve analyses. Conclusions The CHA2DS2-VASc-HS scoring system might be used in daily clinical practice to calculate the total risk assessment of EVAS. This score is relatively simple to use and time-saving technique. Keywords Early vascular aging syndrome · Arterial stiffness · CHADS2 · CHA2DS2-VASc · CHA2DS2-VASc-HS score
1 Introductıon Vascular aging is defined as the continuous deterioration of basic physiological functions in the medial layer of the large artery wall. Both the progressive decrease in the elastin content and an increased amount of collagen as a result of changes in the cell matrix interactions, cause increased arterial stiffness. This condition is associated with many * Onur Baydar [email protected] 1
Department of Cardiology, KOC University Hospital, Istanbul, Turkey
2
Department of Cardiology, Haseki Research and Education Hospital, Istanbul, Turkey
3
Department of Cardiology, Erciyes University, Kayseri, Turkey
cardiovascular diseases such as myocardial infarction, cardiovascular death, heart failure, peripheral artery disease, and stroke [1, 2]. In recent years, the term “early vascular aging syndrome” (EVAS) for increased arterial stiffness compared to matched age and sex is suggested for a better understanding of these processes [
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