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Increases in cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation.

Authors
 Young Dae Kim  ;  Myoung Jin Cha  ;  Jinkwon Kim  ;  Dong Hyun Lee  ;  Hye Sun Lee  ;  Chung Mo Nam  ;  Hyo Suk Nam  ;  Ji Hoe Heo 
Citation
 STROKE, Vol.42(4) : 930-934, 2011 
Journal Title
 STROKE 
ISSN
 0039-2499 
Issue Date
2011
MeSH
Atrial Fibrillation/epidemiology* ; Atrial Fibrillation/physiopathology ; Cerebral Arteries/diagnostic imaging ; Cerebral Arteries/pathology ; Cerebral Arteries/physiopathology ; Comorbidity/trends ; Constriction, Pathologic/epidemiology ; Constriction, Pathologic/physiopathology ; Disability Evaluation ; Disease Progression ; Humans ; Incidence ; Intracranial Arteriosclerosis/epidemiology* ; Intracranial Arteriosclerosis/physiopathology ; Multivariate Analysis ; Prospective Studies ; Radiography ; Risk Factors ; Severity of Illness Index ; Stroke/epidemiology* ; Stroke/physiopathology
Keywords
atherosclerosis ; atrial fibrillation ; CHADS2 score ; stroke
Abstract
BACKGROUND AND PURPOSE: The CHADS(2) score is used for risk stratification of ischemic stroke in patients with nonvalvular atrial fibrillation and high CHADS(2) scores are associated with increased risk of stroke. Most components of the CHADS(2) score are also risk factors for atherosclerosis. Therefore, high CHADS(2) scores can be associated with concomitant cerebral atherosclerosis and subsequently atherothrombotic stroke. The aim of this study was to determine whether there are differences in the presence and burden of concomitant cerebral atherosclerosis according to CHADS(2) scores in patients with stroke with nonvalvular atrial fibrillation. METHODS: We included 780 consecutive patients with nonvalvular atrial fibrillation who had undergone angiographic studies at index stroke between August 1994 and March 2010 in the present study. We investigated the relationships between the CHADS(2) score and the presence, severity, and pattern of cerebral atherosclerosis and stroke mechanism. RESULTS: Of the 780 patients, concomitant arterial stenosis (≥50%) was found in 231 patients (29.6%). The number of arteries with atherosclerosis increased as the CHADS(2) score increased (P<0.001) as did the proportion of combined extracranial and intracranial atherosclerosis (P<0.001). Multivariate analyses showed that high risk based on the CHADS(2) score was an independent predictor of concomitant cerebral atherosclerosis (OR, 3.121; 95% CI, 1.770 to 5.504) and the presence of proximal stenosis at the symptomatic artery (OR, 3.043; 95% CI, 1.458 to 6.350). CONCLUSIONS: The CHADS(2) score can predict the presence of concomitant cerebral artery atherosclerosis. Increased risk of stroke in patients with high CHADS(2) scores may be partly explained by increased frequency and burden of cerebral atherosclerosis
Files in This Item:
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DOI
10.1161/STROKEAHA.110.602987
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 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
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/22282913/92825
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