The CHA2DS2‐VASc risk score predicts successful endovascular treatment in patients with acute ischemic stroke

Yaşar, Erdoğan; Akalin, Yahya; Aktaş, İbrahim; Çakmak, Tolga; Karakuş, Yasin; Bayramoğlu, Adil

doi:10.1111/ane.13564

Cited by 7 publications

(5 citation statements)

References 41 publications

(39 reference statements)

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“…As a result of this study, the CHA2DS2-VASc score was found to be significantly higher in the patient group with mTICI flow < 2c (2.78 ±1.44, 5.02 ±1.77, p < 0.001). In addition, a CHA2DS2-VASc score ≥ 3 was determined as a predictor of a failed attempt (area under the curve (AUC) = 0.827, 95% CI: 0.739–0.895, p < 0.001) [ 17 ]. Similarly, in our study, the CHA2DS2-VASc score of the patients with a flow < mTICI 2c after thrombectomy was found to be significantly higher than in the patients with a flow of mTICI 2c and 3 (4.1 ±1.5 vs. 3.04 ±1.6, p = 0.002).…”

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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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

View full text Add to dashboard Cite

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“…Data on patient characteristics, laboratory data, risk of ischemic stroke (CHA 2 DS 2 -VASc score), and risk of hemorrhagic stroke (HAS-BLED score) were collected [ 11 ]. The CHA 2 DS 2 -VASc score was developed to predict thrombotic events in patients with AF and consists of congestive heart failure, hypertension, age ≥75 years, diabetes mellitus (DM), previous stroke, vascular disease, age of 65–74 years, and female sex [ 13 ]. The HAS-BLED score was developed to predict major bleeding events in anticoagulation for patients with AF and is composed of hypertension, abnormal renal or liver function, stroke, bleeding history or predisposition, labile PT-INR of anticoagulation, age >65 years, and concomitant use of drugs and alcohol [ 11 , 14 ].…”

Section: Methodsmentioning

confidence: 99%

Effect of current smoking on ischemic events in patients with atrial fibrillation taking vitamin K antagonist

Arai

Ueda

Uchida

et al. 2022

International Journal of Cardiology Cardiovascular Risk and Pre

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“…Atorvastatin alleviates oxidative damage by activating the nuclear factor erythroid 2-related factor 2 pathway after brain ischemia in mice and anti-coagulation therapies, among others (3)(4)(5). However, these treatment methods have limited therapeutic efficacy, more contraindications, and bleeding risks, and as such, only few patients can benefit from them (6).…”

Section: Original Articlementioning

confidence: 99%

Atorvastatin alleviates oxidative damage by activating the nuclear factor erythroid 2-related factor 2 pathway after brain ischemia in mice

Fan¹,

Zhang²,

Chen³

2022

Ann Transl Med

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Background: Exploring anti-oxidative stress drugs are essential to prevent and treat ischemic cerebral infarction. The present study was designed to explore the antioxidant molecular mechanism of atorvastatin underlying ischemic cerebral infarction.Methods: Male, Nrf2+/+ and Nrf2−/− mice were subjected to distal middle cerebral artery occlusion (dMCAO). Mice were treated with atorvastatin or vehicle daily for 7 days before surgery until sampling or continuous administration 3 days after surgery. Motor function was measured before and after surgery at 24, 48 and 72 h respectively. The brain water content and infarct volume were monitored. ELISA, Western blot, and immunofluorescence staining were used to analyze the expression of Nrf2 and autophagy-related proteins.Results: We found that 20 mg/kg atorvastatin significantly improved the neurological impairment of mice, reduced the volume of cerebral infarction, rescued cerebral edema, and showed a protective effect on the brain. Compared with vehicle administration, atorvastatin-treated mice potently significantly attenuated oxidative damage and promoted Nrf2 nuclear translocation after dMCAO in Nrf2+/+ mice. While atorvastatin's anti-oxidative damage role was invalided in the Nrf2−/− mice. Atorvastatin up-regulated the expression of autophagy-related genes and might protect against oxidative stress by activating autophagy.Atorvastatin activated the Nrf2 signaling pathway and exerted an antioxidant activity, so as to improve the neurological function recovery of stroke in mice.Conclusions: Atorvastatin exhibited an antioxidant activity by activating Nrf2 signaling pathway and activating autophagy, so as to protect the brain from damage caused by dMCAO.

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The CHA2DS2‐VASc risk score predicts successful endovascular treatment in patients with acute ischemic stroke

Cited by 7 publications

References 41 publications

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

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

Effect of current smoking on ischemic events in patients with atrial fibrillation taking vitamin K antagonist

Atorvastatin alleviates oxidative damage by activating the nuclear factor erythroid 2-related factor 2 pathway after brain ischemia in mice

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