机构:[1]Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China老年医学科首都医科大学宣武医院[2]Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China心脏科(内科专业)首都医科大学宣武医院
Background: CHADS2 and CHA2 DS2-VASc scores are validated tools for assessing stroke risk in patients with atrial fibrillation. We aimed to investigate the correlation of CHA2DS2-VASc and CHADS2 scores with short-term prognosis in acute ischemic stroke patients with non-valvular atrial fibrillation (NVAF) in elderly patients. Methods: A total of 216 patients with non-valvular atrial fibrillation were enrolled in this study. Consecutive ischemic stroke patients with non-valvular atrial fibrillation who were hospitalized within 7 days after stroke were registered. Patients were divided into 3 groups on the basis of CHADS2 scores (0, 1, 2 to 6) and CHA2DS2-VASc score (0, 1, 2 to 9). And recovery was assessed by modified Rankin Scale (mRS) at 3 months follow-up (mRS <= 2 reflected good prognosis and mRS >= 3 implicated unfavorable outcome). After screening the risk factors affecting prognosis using univariate analysis, the correlation of CHADS2 and CHA2DS2-VASc scores for short-term prognosis was estimated using Logistic regression model. Results: A total of 206 cases (95.3%) were included in the study. The groups with CHADS2 scores of 0, 1, and 2-6 points contained 31, 83, and 92 cases, respectively, while the groups with CHA2DS2-VASc scores of 0, 1, and 2-9 points had 22, 78, and 106 cases, respectively. There were 89 (43.2%) patients with good prognoses and 117 (56.8%) with poor prognoses. The proportion of high-risk group was significantly higher (P<0.01) while that of low-risk group significantly lower as stratified by CHA2DS2-VASc score than by CHADS2 scores (P<0.01). High-risk (>= 2) CHADS2 and CHA2DS2-VASc scores are both associated with 3-month poor functional outcomes (CHADS2: OR 2.85, 1.32-4.05; CHA2DS2-VASc: OR 3.24, 1.32-6.98) after adjusting for baseline differences in age, sex and neurological impairment. The CHA2DS2-VASc score is better than the CHADS2 score in estimating 3-month stroke outcomes in acute ischemic stroke patients with nonvalvular atrial fibrillation. Conclusions: The CHA2DS2-VASc score appears to be a simple tool for identifying patients at lower risk of poor outcomes and serious cardiac complications within 3 months following ischemic stroke in patients with AF.
基金:
the Hypertension Molecular Classification and Individualized Diagnosis and Treatment Technology Research (No. 2012AA02A51).
第一作者机构:[1]Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China
通讯作者:
通讯机构:[*1]Department of Cardiology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China.
推荐引用方式(GB/T 7714):
Zichen Wang,Qi Hua,Yun Li,et al.CHA2DS2-VASc can better predict short-term prognosis in acute ischemic stroke patients with non-valvular atrial fibrillation[J].INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE.2016,9(3):6758-6764.
APA:
Zichen Wang,Qi Hua,Yun Li,Yuying Qian,Zhanyun Wei&Wei Yang.(2016).CHA2DS2-VASc can better predict short-term prognosis in acute ischemic stroke patients with non-valvular atrial fibrillation.INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE,9,(3)
MLA:
Zichen Wang,et al."CHA2DS2-VASc can better predict short-term prognosis in acute ischemic stroke patients with non-valvular atrial fibrillation".INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE 9..3(2016):6758-6764