title: CHA2DS2-VASc score in the prediction of ischemic bowel disease among patients with atrial fibrillation: Insights from a nationwide cohort.
abstract: OBJECTIVE
  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.
authors.affiliation: School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan; Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan. Electronic address: weisyunhu@gmail.com.
authors.forename: Wei-Syun
authors.initials: WS
authors.lastname: Hu
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D065666:Mesenteric Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012107:Research Design / Q000592:standards; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Atrial fibrillation; CHA(2)DS(2)-VASc score; Cohort; Ischemic bowel disease