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Novel composite scoring system to predict unknown atrial fibrillation in acute ischemic stroke patients

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机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, 6 Tiantanxili, Beijing 100050, Peoples R China
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关键词: CHADS(2) score CHA(2)DS(2)-VASc score Atrial fibrillation Stroke

摘要:
Objectives: The aim of the study is to ascertain whether a new risk-stratification scheme that combination of CHADS(2) or CHA(2)DS(2)-VASc score and neuroimaging features could reliably predict unknown AF in patients with acute ischemic stroke. Methods: From October 2013 to June 2015, patients from 20 hospitals throughout China were selected from the study of Atrial Fibrillation Screening in the patients with acute ischemic stroke and transient ischemic attack (TIA). Brain imaging characteristics in prediction of AF detection were analyzed with multivariate logistic regressions. The clinical prediction of the models was examined using the C-statistic. Results: Among the 661 patients, previously undetected AF was in 53 patients (8.02%). Age, history of congestive heart failure, acute cortical involvement, acute insular cortex involvement, and prior cortical infarction were independently associated with newly detected AF. Using CHADS(2) and CHA(2)DS(2)-VASc scores, C statistics for newly detected AF was 0.54 (OR 1.11, 95% CI: 0.88-1.38) and 0.58 (OR 1.17, 95% CI: 0.99-1.38), respectively; adding newly identified AF-associated imaging characteristics to the two scores, the value of C statistic was significantly improved to 0.74 (P < 0.001) and 0.75 (P < 0.001), respectively. Conclusion: Both CHADS(2) and CHA(2)DS(2)-VASc scores are useful but not optimal for predicting newly detected AF in patients with acute ischemic stroke. A newly identified embolic features combining with the CHADS(2) or CHA(2)DS(2)-VASc score for predicting AF in patients with stroke is superior to the CHADS2 or CHA(2)DS(2)-VASc score alone. (C) 2017 Elsevier B.V. All rights reserved.

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中科院(CAS)分区:
出版当年[2016]版:
大类 | 3 区 医学
小类 | 4 区 神经科学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 神经科学
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出版当年[2015]版:
Q3 NEUROSCIENCES
最新[2023]版:
Q3 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

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第一作者机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, 6 Tiantanxili, Beijing 100050, Peoples R China
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, 6 Tiantanxili, Beijing 100050, Peoples R China
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