Cited 91 times in
Dynamic Changes of CHA2DS2-VASc Score and the Risk of Ischaemic Stroke in Asian Patients with Atrial Fibrillation: A Nationwide Cohort Study
DC Field | Value | Language |
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dc.contributor.author | 김종윤 | - |
dc.contributor.author | 김태훈 | - |
dc.contributor.author | 박희남 | - |
dc.contributor.author | 엄재선 | - |
dc.contributor.author | 유희태 | - |
dc.contributor.author | 이문형 | - |
dc.contributor.author | 정보영 | - |
dc.date.accessioned | 2018-08-28T17:29:16Z | - |
dc.date.available | 2018-08-28T17:29:16Z | - |
dc.date.issued | 2018 | - |
dc.identifier.issn | 0340-6245 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/162668 | - |
dc.description.abstract | BACKGROUND: Stroke risk in atrial fibrillation (AF) is often assessed at initial presentation, and risk stratification performed as a 'one off'. In validation studies of risk prediction, baseline values are often used to 'predict' events that occur many years later. Many clinical variables have 'dynamic' changes over time, as the patient is followed up. These dynamic changes in risk factors may increase the CHA2DS2-VASc score, stroke risk category and absolute ischaemic stroke rate. OBJECTIVE: This article evaluates the 'dynamic' changes of CHA2DS2-VASc variables and its effect on prediction of stroke risk. PATIENTS AND METHODS: From the Korea National Health Insurance Service database, a total of 167,262 oral anticoagulant-naive non-valvular AF patients aged >/= 18 years old were enrolled between January 1, 2002, and December 31, 2005. These patients were followed up until December 31, 2015. RESULTS: At baseline, the proportions of subjects categorized as 'low', 'intermediate' or 'high risk' by CHA2DS2-VASc score were 15.4, 10.6 and 74.0%, respectively. Mean CHA2DS2-VASc score increased annually by 0.14, particularly due to age and hypertension. During follow-up of 10 years, 46.6% of 'low-risk' patients and 72.0% of 'intermediate risk' patients were re-classified to higher stroke risk categories. Among the original 'low-risk' patients, annual ischaemic stroke rates were significantly higher in the re-classified 'intermediate' (1.17 per 100 person-years, p < 0.001) or re-classified 'high-risk' groups (1.44 per 100 person-years, p = 0.048) than consistently 'low-risk' group (0.29 per 100 person-years). The most recent CHA2DS2-VASc score and the score change with the longest follow-up had the best prediction for ischaemic stroke. CONCLUSION: In AF patients, stroke risk as assessed by the CHA2DS2-VASc score is dynamic and changes over time. Rates of ischaemic stroke increased when patients accumulated risk factors, and were re-classified into higher CHA2DS2-VASc score categories. Stroke risk assessment is needed at every patient contact, as accumulation of risk factors with increasing CHA2DS2-VASc score translates to greater stroke risks over time. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English, French(Summary), German(Summary) | - |
dc.publisher | Schattauer | - |
dc.relation.isPartOf | THROMBOSIS AND HAEMOSTASIS | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.title | Dynamic Changes of CHA2DS2-VASc Score and the Risk of Ischaemic Stroke in Asian Patients with Atrial Fibrillation: A Nationwide Cohort Study | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine | - |
dc.contributor.department | Dept. of Internal Medicine | - |
dc.contributor.googleauthor | Minjae Yoon | - |
dc.contributor.googleauthor | Pil-Sung Yang | - |
dc.contributor.googleauthor | Eunsun Jang | - |
dc.contributor.googleauthor | Hee Tae Yu | - |
dc.contributor.googleauthor | Tae-Hoon Kim | - |
dc.contributor.googleauthor | Jae-Sun Uhm | - |
dc.contributor.googleauthor | Jong-Youn Kim | - |
dc.contributor.googleauthor | Hui-Nam Pak | - |
dc.contributor.googleauthor | Moon-Hyoung Lee | - |
dc.contributor.googleauthor | Gregory Y H Lip | - |
dc.contributor.googleauthor | Boyoung Joung | - |
dc.identifier.doi | 10.1055/s-0038-1651482 | - |
dc.contributor.localId | A00926 | - |
dc.contributor.localId | A01085 | - |
dc.contributor.localId | A01776 | - |
dc.contributor.localId | A02337 | - |
dc.contributor.localId | A02535 | - |
dc.contributor.localId | A02766 | - |
dc.contributor.localId | A03609 | - |
dc.contributor.localId | A05608 | - |
dc.relation.journalcode | J02726 | - |
dc.identifier.pmid | 29723875 | - |
dc.identifier.url | https://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1651482 | - |
dc.contributor.alternativeName | Kim, Jong Youn | - |
dc.contributor.alternativeName | Kim, Tae Hoon | - |
dc.contributor.alternativeName | Pak, Hui Nam | - |
dc.contributor.alternativeName | Uhm, Jae Sun | - |
dc.contributor.alternativeName | Yu, Hee Tae | - |
dc.contributor.alternativeName | Lee, Moon Hyoung | - |
dc.contributor.alternativeName | Joung, Bo Young | - |
dc.contributor.affiliatedAuthor | Kim, Jong Youn | - |
dc.contributor.affiliatedAuthor | Kim, Tae-Hoon | - |
dc.contributor.affiliatedAuthor | Pak, Hui Nam | - |
dc.contributor.affiliatedAuthor | Uhm, Jae Sun | - |
dc.contributor.affiliatedAuthor | Yu, Hee Tae | - |
dc.contributor.affiliatedAuthor | Lee, Moon Hyoung | - |
dc.contributor.affiliatedAuthor | Joung, Bo Young | - |
dc.contributor.affiliatedAuthor | 김종윤 | - |
dc.contributor.affiliatedAuthor | 김태훈 | - |
dc.contributor.affiliatedAuthor | 박희남 | - |
dc.contributor.affiliatedAuthor | 엄재선 | - |
dc.contributor.affiliatedAuthor | 유희태 | - |
dc.contributor.affiliatedAuthor | 이문형 | - |
dc.contributor.affiliatedAuthor | 정보영 | - |
dc.citation.volume | 118 | - |
dc.citation.number | 7 | - |
dc.citation.startPage | 1296 | - |
dc.citation.endPage | 1304 | - |
dc.identifier.bibliographicCitation | THROMBOSIS AND HAEMOSTASIS, Vol.118(7) : 1296-1304, 2018 | - |
dc.identifier.rimsid | 60247 | - |
dc.type.rims | ART | - |
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