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Early neurological outcomes according to CHADS2 score in stroke patients with non-valvular atrial fibrillation.

Title
 Early neurological outcomes according to CHADS2 score in stroke patients with non-valvular atrial fibrillation. 
Authors
 H. J. Hong ; Y. D. Kim ; J. H. Heo ; H. S. Nam ; C. M. Nam ; H. S. Lee ; D. H. Lee ; J. Kim ; M.-J. Cha 
Issue Date
2012
Journal Title
 European Journal of Neurology 
ISSN
 1351-5101 
Citation
 European Journal of Neurology, Vol.19(2) : 284~290, 2012 
Abstract
BACKGROUND AND PURPOSE: A higher CHADS(2) score or CHA(2)DS(2)-VASc score is associated with an increased risk of ischaemic stroke in patients with non-valvular atrial fibrillation (NVAF). However, there are no data regarding early neurological outcomes after stroke according to the risk levels. METHODS: In this study, a total of 649 stroke patients with NVAF were enrolled and categorized into three groups: low-risk (CHADS(2) score of 0-1), moderate-risk (CHADS(2) score 2-3), or high-risk group (CHADS(2) score ≥4). CHA(2)DS(2)-VASc score was divided into four groups including 0-1, 2-3, 4-5, and ≥6. We investigated whether there were differences in initial stroke severity, early neurological outcome, and infarct size according to CHADS(2) score or CHA(2)DS(2)-VASc score in stroke patients with NVAF. RESULTS: The initial National Institutes of Health Stroke Scale (NIHSS) score was highest in high-risk group [9.5, interquartile range (IQR) 4-18], followed by moderate-risk (8, IQR 2-17) and low-risk group (6, IQR 2-15) (P=0.012). Likewise, initial stroke severity increased in a positive fashion with increasing the CHA(2)DS(2)-VASc score. During hospitalization, those in the high-risk group or higher CHA(2)DS(2)-VASc score had less improvement in their NIHSS score. Furthermore, early neurological deterioration (END) developed more frequently as CHADS(2) score or CHA(2)DS(2)-VASc score increased. Multivariate analysis showed being in the high-risk group was independently associated with END (OR 2.129, 95% CI 1.013-4.477). CONCLUSIONS: Our data indicate that patients with NVAF and higher CHADS(2) score or CHA(2)DS(2)-VASc score are more likely to develop severe stroke and a worse clinical course is expected in these patients after stroke presentation.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/90205
DOI
10.1111/j.1468-1331.2011.03518.x
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Preventive Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Neurology
1. 연구논문 > 1. College of Medicine > Yonsei Biomedical Research Center
Yonsei Authors
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Link
 http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1331.2011.03518.x/abstract
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