中国普通外科杂志2026，Vol.35Issue(6)：1173-1180,8.DOI:10.7659/j.issn.1005-6947.250379
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
Association between CHA2DS2-VASc score and aortic calcification in patients with atrial fibrillation and its sex-specific predictive value
摘要
Abstract
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.关键词
主动脉疾病/血管钙化/CHA2DS2-VASc评分/心房颤动/危险因素Key words
Aortic Diseases/Vascular Calcification/Atrial Fibrillation/CHA2DS2-VASc Score/Risk Factors分类
医药卫生引用本文复制引用
吴甜,石灿,连慧琳,陈松华,张思仪,郭韧,李筱旻,李岱..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[J].中国普通外科杂志,2026,35(6):1173-1180,8.基金项目
国家自然科学基金资助项目(82504928) （82504928）
湖南省自然科学基金资助项目(2025JJ50666,2025JJ50595,2024JJ8154). （2025JJ50666,2025JJ50595,2024JJ8154）
