Pre-admission CHA2DS2-VASc score and outcome of patients with acute cerebrovascular events

Topaz, Guy; Pereg, David; Shuvy, Mony; Mausbach, Stefan; Kimiagar, Itzhak; Telman, Gregory; Kitay-Cohen, Yona; Vorobeichik, Dina; Nir, Shlomo; Tanné, David

doi:10.1016/j.ijcard.2017.06.057

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…Previous studies have proven the relationship between stroke risk scores and the clinical outcome of stroke. CHADS 2 , CHA 2 DS 2 -VASc, and ATRIA scores are simple to obtain and are useful tools for estimating the thromboembolic risk and clinical outcomes in patients with AF [ 15 , 16 , 17 , 18 ]. The Essen score is a simple clinical score that was derived to predict the 1-year risk of recurrent ischemic stroke after ischemic stroke based on the presence of prior vascular comorbidities [ 13 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Essen score is a simple clinical score that was derived to predict the 1-year risk of recurrent ischemic stroke after ischemic stroke based on the presence of prior vascular comorbidities [ 13 , 19 ]. Unlike the purpose for which the stroke risk scores were developed, the stroke risk scores have been used as a predictor of various outcomes in various patient groups [ 15 , 20 , 21 ]. Our results are meaningful in that they provide additional information that CHADS 2 , CHA 2 DS 2 -VASc, ATRIA, and Essen scores were correlated with unsuccessful recanalization in patients undergoing EVT, as well as thromboembolic risk and clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

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Association between CHADS2, CHA2DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients

Kim

Park

Yoo

et al. 2022

JCM

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Background: The CHADS2, CHA2DS2-VASc, ATRIA, and Essen scores have been developed for predicting vascular outcomes in stroke patients. We investigated the association between these stroke risk scores and unsuccessful recanalization after endovascular thrombectomy (EVT). Methods: From the nationwide multicenter registry (Selection Criteria in Endovascular Thrombectomy and Thrombolytic therapy (SECRET)) (Clinicaltrials.gov NCT02964052), we consecutively included 501 patients who underwent EVT. We identified pre-admission stroke risk scores in each included patient. Results: Among 501 patients who underwent EVT, 410 (81.8%) patients achieved successful recanalization (mTICI ≥ 2b). Adjusting for body mass index and p < 0.1 in univariable analysis revealed the association between all stroke risk scores and unsuccessful recanalization (CHADS2 score: odds ratio (OR) 1.551, 95% confidence interval (CI) 1.198–2.009, p = 0.001; CHA2DS2VASc score: OR 1.269, 95% CI 1.080–1.492, p = 0.004; ATRIA score: OR 1.089, 95% CI 1.011–1.174, p = 0.024; and Essen score: OR 1.469, 95% CI 1.167–1.849, p = 0.001). The CHADS2 score had the highest AUC value and differed significantly only from the Essen score (AUC of CHADS2 score; 0.618, 95% CI 0.554–0.681). Conclusion: All stroke risk scores were associated with unsuccessful recanalization after EVT. Our study suggests that these stroke risk scores could be used to predict recanalization in stroke patients undergoing EVT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association between CHADS2, CHA2DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients

Kim

Park

Yoo

et al. 2022

JCM

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“…In many cases, the prevalence of LA SEC was shown to increase as CHADS 2 /CHA 2 DS 2 -VASc score became higher (37, 38). A possible explanation for this association is that an elevated CHADS 2 /CHA 2 DS 2 -VASc score is often accompanied by conditions predisposed to thrombosis, such as increased LA volume and impaired LV systolic function (39, 40).…”

Section: La Sec and Chads2/cha2ds2-vasc Scoresmentioning

confidence: 99%

Left atrial spontaneous echo contrast: relationship with clinical and echocardiographic parameters

Ito

Suwa

2019

Echo Res Pract

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Spontaneous echo contrast (SEC) indicates blood stasis in cardiac chambers and major vessels, and is a known precursor of thrombus formation. Transesophageal echocardiography plays a pivotal role in detecting and grading SEC in the left atrial (LA) cavity. Assessing LA SEC can identify patients at increased risk for thromboembolic events. LA SEC also develops in patients who have sinus rhythm, especially in those with heart failure. Detection of LA SEC is not uncommon in subjects who have multiple cardiovascular comorbidities, although mechanisms behind this association are not fully understood. In patients with atrial fibrillation, the role of mitral regurgitation in counteracting LA SEC and subsequent thromboembolism is controversial. Moreover, alterations of blood coagulability and elevated levels of certain biological markers in the blood contribute to occurrence of LA SEC. This review describes the pathogenesis and assessment of SEC, in addition to the relationship between LA SEC and clinical, biological and echocardiographic parameters.

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“…The CHA2DS2-VASc score is a widely used scoring system for regulation of anticoagulant therapy in patients with AF. Many studies have shown that this scoring system also affects prognosis in some diseases other than AF [10][11][12][13]. In a study of AF-related cardioembolic stroke patients, Nezu et al found a positive correlation between the CHA2DS2-VASc score and the NIHSS score, which indicates the severity of stroke [12].…”

Section: Discussionmentioning

confidence: 99%

Association of CHA2DS2-VASc score with successful recanalization in acute ischemic stroke patients undergoing endovascular thrombectomy

Nasifov¹,

Özmen²,

Deniz³

et al. 2022

pwki

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Introduction:The CHA2DS2-VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke, vascular disease and sex) score is a simple risk stratification algorithm to estimate stroke/thromboembolic risk in patients with non-valvular atrial fibrillation (AF). Higher pre-stroke CHA2DS2-VASc score is known to be associated with greater stroke severity and poorer outcomes. AF patients generally have higher CHA2DS2-VASc scores than non-AF patients. The Modified Thrombolysis in Cerebral Infarction (mTICI) score is the most widely used grading system to assess the result of recanalizing therapies in acute ischemic stroke (AIS). mTICI 2c and mTICI 3 are conventionally accepted as successful recanalization.Aim: We investigated whether pre-stroke CHA2DS2-VASc score is associated with mTICI recanalization score in AIS patients with and without AF undergoing percutaneous thrombectomy.Material and methods: One hundred fifty-nine patients with the diagnosis of AIS who were admitted within 6 h from symptom onset were included in the study (mean age: 65.7 ±12.9). All subjects underwent endovascular treatment. CHA2DS2-VASc scores of the participants were calculated. Subjects were grouped according to mTICI scores achieved after endovascular treatment. mTICI 2c and mTICI 3 were accepted as successful recanalization.Results: Successful reperfusion was observed in 130 (81.8%) of all patients who underwent endovascular treatment (mTICI flow ≥ 2c) and first-pass reperfusion was observed in 107 (67.3%) patients. When the patients with successful (mTICI flow ≥ 2c) and unsuccessful (mTICI flow ≤ 2b) reperfusion were divided into groups, no significant difference was observed between the patients in terms of comorbidities such as AF, hypertension, hyperlipidemia, coronary artery disease and cerebrovascular accident history. Patients with unsuccessful reperfusion were older than patients with successful reperfusion (71.4 ±11.2 vs. 64.5 ±13.01, p = 0.006), with a higher CHA2DS2-VASc score (4.1 ±1.5 vs. 3.04 ±1.6, p = 0.002). In addition, the duration of the procedure was longer in the unsuccessful reperfusion group (92.4 ±27.2 min vs. 65.0 ±25.1 min, p < 0.001). CHA2DS2-VASc score significantly correlated with successful recanalization (correlation coefficient; 0.243, p = 0.002). Multivariate logistic regression analysis revealed that only CHA2DS2-VASc score (OR = 1.43, 95% CI: 1.09-1.87, p = 0.006) and procedure time (OR = 1.03, 95% CI: 1.01-1.05, p < 0.001) were independent predictors of successful reperfusion. The receiver-operating characteristic (ROC) curve was used to determine the cutoff value for the CHA2DS2-VASc score that best predicts successful reperfusion. The optimal threshold was 3.5, with a sensitivity of 58.6% and specificity of 59.2% (area under the curve (AUC): 0.669, p = 0.005).Conclusions: For the first time in the literature, we investigated and demonstrated that pre-stroke CHA2DS2-VASc score was associated with success of recanalization as assessed with mTICI 2c and mTICI 3 in a cohort of AIS patients reg...

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Pre-admission CHA2DS2-VASc score and outcome of patients with acute cerebrovascular events

Cited by 7 publications

References 11 publications

Association between CHADS2, CHA2DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients

Association between CHADS2, CHA2DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients

Left atrial spontaneous echo contrast: relationship with clinical and echocardiographic parameters

Association of CHA2DS2-VASc score with successful recanalization in acute ischemic stroke patients undergoing endovascular thrombectomy

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