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

Authors
 H. J. Hong  ;  Y. D. Kim  ;  M.-J. Cha  ;  J. Kim  ;  D. H. Lee  ;  H. S. Lee  ;  C. M. Nam  ;  H. S. Nam  ;  J. H. Heo 
Citation
 EUROPEAN JOURNAL OF NEUROLOGY, Vol.19(2) : 284-290, 2012 
Journal Title
 EUROPEAN JOURNAL OF NEUROLOGY 
ISSN
 1351-5101 
Issue Date
2012
MeSH
Adult ; Aged ; Aged, 80 and over ; Atrial Fibrillation/complications ; Atrial Fibrillation/physiopathology* ; Brain Ischemia/complications ; Brain Ischemia/physiopathology* ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Registries ; Risk ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Stroke/complications ; Stroke/physiopathology* ; Treatment Outcome
Keywords
atrial fibrillation ; CHADS2 score ; outcome ; stroke
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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1468-1331.2011.03518.x/abstract
DOI
21914056
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Kim, Jinkwon(김진권) ORCID logo https://orcid.org/0000-0003-0156-9736
Nam, Jung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Lee, Dong Hyun(이동현)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Cha, Myoung Jin(차명진)
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90205
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