title: R2CHADS2 score is significantly associated with ankle-brachial index <0.9 in patients without atrial fibrillation.
abstract: OBJECTIVE
  Previous studies demonstrated CHADS2 score and impaired renal function were both associated with ankle-brachial index (ABI) < 0.9 in patients without atrial fibrillation (AF). Hence, we hypothesized the R2CHADS2 score had a significant correlation with ABI < 0.9 and the aim of this study was to validate this association in non-AF patients.
  
  
  METHODS
  A total of 1482 patients without AF were included. ABI was measured using an ABI-form device. Peripheral arterial occlusive disease (PAOD) was defined as ABI < 0.9 in either leg.
  
  
  RESULTS
  Of the 1482 subjects, the prevalence of ABI < 0.9 was 5.6%. Multivariate analysis showed that increased age (odds ratio [OR], 1.049; P < 0.001), decreased estimated glomerular filtration rate (OR, 0.978; P = 0.006), and increased R2CHADS2 score (OR, 1.738; P < 0.001) were associated with ABI < 0.9. In addition, in patients with CHADS2 score ≧ 2, the presence of chronic kidney disease (CKD) was significantly associated with ABI < 0.9 (P ≦ 0.006), but in patients with CHADS2 score < 2, there was no such association (P = 0.357).
  
  
  CONCLUSIONS
  Our study demonstrated R2CHADS2 score was positively correlated with ABI < 0.9. In addition, the presence of CKD was a risk factor of ABI < 0.9 in patients with CHADS2 score ≧ 2. Hence, increased R2CHADS2 score in non-AF patients and the presence of CKD in non-AF patients with CHADS2 score ≧ 2 were useful parameters in identifying the high risk group of PAOD.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Po-Chao
authors.initials: PC
authors.lastname: Hsu
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Wen-Hsien
authors.initials: WH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Cheng-An
authors.initials: CA
authors.lastname: Chiu
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chun-Yuan
authors.initials: CY
authors.lastname: Chu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Szu-Chia
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: cobeshm@seed.net.tw.
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Wen-Chol
authors.initials: WC
authors.lastname: Voon
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
mesh_terms: D000367:Age Factors; D000368:Aged; D055109:Ankle Brachial Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D012008:Recurrence; D018570:Risk Assessment; D012494:Sampling Studies; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*; D011795:Surveys and Questionnaires
chemical_list: D008055:Lipids
keywords: Ankle–brachial index; CHADS(2) score; Estimated glomerular filtration rate; Peripheral arterial occlusive disease; R(2)CHADS(2) score