Abstract

We investigated a multicenter registry to identify estimated event rates according to CHA2DS2-VASc scores in patients with acute ischemic stroke (AIS) and atrial fibrillation (AF). The additional effectiveness of antiplatelets (APs) plus oral anticoagulants (OACs) compared with OACs alone considering the CHA2DS2-VASc scores was also explored. This study retrospectively analyzed a multicenter stroke registry between Jan 2011 and Nov 2017, identifying patients with acute ischemic stroke with AF. The primary outcome event was a composite of recurrent stroke, myocardial infarction, and all-cause mortality within 1 year. A total of 7395 patients (age, 73 ± 10 years; men, 54.2%) were analyzed. The primary outcome events at one year ranged from 5.99% (95% CI 3.21–8.77) for a CHA2DS2-VASc score of 0 points to 30.45% (95% CI 24.93–35.97) for 7 or more points. After adjustments for covariates, 1-point increases in the CHA2DS2-VASc score consistently increased the risk of primary outcome events (aHR 1.10 [1.06–1.15]) at 1-year. Among OAC-treated patients at discharge (n = 5500), those treated with OAC + AP (vs. OAC alone) were more likely to experience vascular events, though among patients with a CHA2DS2-VASc score of 5 or higher, the risk of primary outcome in the OAC + AP group was comparable to that in the OAC alone group (Pint = 0.01). Our study found that there were significant associations of increasing CHA2DS2-VASc scores with the increasing risk of vascular events at 1-year in AIS with AF. Further study would be warranted.

Details

Title
CHA2DS2-VASc score in acute ischemic stroke with atrial fibrillation: results from the Clinical Research Collaboration for Stroke in Korea
Author
Hak-Loh, Lee 1 ; Joon-Tae, Kim 1 ; Lee Ji Sung 2 ; Kim, Beom Joon 3 ; Jong-Moo, Park 4 ; Kang Kyusik 4 ; Lee Soo Joo 5 ; Kim Jae Guk 5 ; Jae-Kwan, Cha 6 ; Dae-Hyun, Kim 6 ; Park, Tai Hwan 7 ; Sang-Soon, Park 7 ; Lee, Kyung Bok 8 ; Lee, Jun 9 ; Keun-Sik, Hong 10 ; Yong-Jin, Cho 10 ; Hong-Kyun, Park 10 ; Lee, Byung-Chul 11 ; Kyung-Ho, Yu 11 ; Oh Mi Sun 11 ; Dong-Eog, Kim 12 ; Wi-Sun, Ryu 12 ; Choi, Jay Chol 13 ; Jee-Hyun, Kwon 14 ; Wook-Joo, Kim 14 ; Dong-Ick, Shin 15 ; Sohn, Sung Il 16 ; Jeong-Ho, Hong 16 ; Man-Seok, Park 17 ; Kang-Ho, Choi 17 ; Ki-Hyun, Cho 17 ; Lee, Juneyoung 18 ; Bae Hee-Joon 3 

 Chonnam National University Medical School, Chonnam National University Hospital, Department of Neurology, Gwangju, Korea 
 University of Ulsan College of Medicine, Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea (GRID:grid.267370.7) (ISNI:0000 0004 0533 4667) 
 Seoul National University Bundang Hospital, Department of Neurology, Cerebrovascular Center, Seoul National University College of Medicine, Seongnam-si, Korea (GRID:grid.412480.b) (ISNI:0000 0004 0647 3378) 
 Eulji University, Department of Neurology, Nowon Eulji Medical Center, Seoul, Korea (GRID:grid.255588.7) (ISNI:0000 0004 1798 4296) 
 Eulji University, Department of Neurology, Eulji University Hospital, Daejeon, Korea (GRID:grid.255588.7) (ISNI:0000 0004 1798 4296) 
 Dong-A University Hospital, Department of Neurology, Busan, Korea (GRID:grid.412048.b) (ISNI:0000 0004 0647 1081) 
 Seoul Medical Center, Department of Neurology, Seoul, Korea (GRID:grid.415520.7) (ISNI:0000 0004 0642 340X) 
 Soonchunhyang University Hospital, Department of Neurology, Seoul, Korea (GRID:grid.412678.e) (ISNI:0000 0004 0634 1623) 
 Yeungnam University Hospital, Department of Neurology, Daegu, Korea (GRID:grid.413040.2) (ISNI:0000 0004 0570 1914) 
10  Inje University, Department of Neurology, Ilsan Paik Hospital, Goyang, Korea (GRID:grid.411612.1) (ISNI:0000 0004 0470 5112) 
11  Hallym University Sacred Heart Hospital, Department of Neurology, Anyang, Korea (GRID:grid.488421.3) (ISNI:0000000404154154) 
12  Dongguk University Ilsan Hospital, Department of Neurology, Goyang, Korea (GRID:grid.470090.a) (ISNI:0000 0004 1792 3864) 
13  Jeju National University School of Medicine, Department of Neurology, Jeju National University Hospital, Jeju, Korea (GRID:grid.411277.6) (ISNI:0000 0001 0725 5207) 
14  Ulsan University College of Medicine, Department of Neurology, Ulsan, Korea (GRID:grid.267370.7) (ISNI:0000 0004 0533 4667) 
15  Chungbuk National University Hospital, Department of Neurology, Cheongju, Korea (GRID:grid.411725.4) (ISNI:0000 0004 1794 4809) 
16  Keimyung University Dongsan Medical Center, Department of Neurology, Daegu, Korea (GRID:grid.414067.0) (ISNI:0000 0004 0647 8419) 
17  Chonnam National University Medical School, Chonnam National University Hospital, Department of Neurology, Gwangju, Korea (GRID:grid.414067.0) 
18  Korea University College of Medicine, Department of Biostatistics, Seoul, Korea (GRID:grid.222754.4) (ISNI:0000 0001 0840 2678) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2477090767
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.