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.
基金:
Ministry of Science and Technology of the People's Republic of ChinaMinistry of Science and Technology, China [2011BAI08B02, 2012ZX09303, 2013BAI09B03]; Beijing Institute for Brain Disorders [BIBD-PXM2013_014226_07_000084]
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
推荐引用方式(GB/T 7714):
Liu Rixia,Yang Xiaomeng,Li Shuya,et al.Novel composite scoring system to predict unknown atrial fibrillation in acute ischemic stroke patients[J].BRAIN RESEARCH.2017,1674:36-41.doi:10.1016/j.brainres.2017.08.005.
APA:
Liu, Rixia,Yang, Xiaomeng,Li, Shuya,Jiang, Yong,Wang, Yilong&Wang, Yongjun.(2017).Novel composite scoring system to predict unknown atrial fibrillation in acute ischemic stroke patients.BRAIN RESEARCH,1674,
MLA:
Liu, Rixia,et al."Novel composite scoring system to predict unknown atrial fibrillation in acute ischemic stroke patients".BRAIN RESEARCH 1674.(2017):36-41