Prestroke $CHA_{2}DS_{2}-VASc$ score and severity of acute stroke in patients with atrial fibrillation : findings from RAF study

Acciarresi, Monica

Paciaroni, Maurizio

Agnelli, Giancarlo

Falocci, Nicola

Caso, Valeria

Becattini, Cecilia

Marcheselli, Simona

Rueckert, Christina

Pezzini, Alessandro

Morotti, Andrea

Costa, Paolo

Padovani, Alessandro

Csiba, Laszlo

Szabo, Lilla

Sohn, Sung-Il

Tassinari, Tiziana

Abdul-Rahim, Azmil H.

Michel, Patrik

Cordier, Maria

Vanacker, Peter

Background and Purpose: The aim of this study was to investigate for a possible association between both prestroke CHA(2)DS(2)-VASc score and the severity of stroke at presentation, as well as disability and mortality at 90 days, in patients with acute stroke and atrial fibrillation (AF). Methods: This prospective study enrolled consecutive patients with acute ischemic stroke, AF, and assessment of prestroke CHA2DS2-VASc score. Severity of stroke was assessed on admission using the National Institutes of Health Stroke Scale (NIHSS) score (severe stroke: NIHSS >= 10). Disability and mortality at 90 days were assessed by the modified Rankin Scale (mRS < 3 or >= 3). Multiple logistic regression was used to correlate prestroke CHA(2)DS(2)-VASc and severity of stroke, as well as disability and mortality at 90 days. Results: Of the 1020 patients included in the analysis, 606 patients had an admission NIHSS score lower and 414 patients higher than 10. At 90 days, 510 patients had mRS >= 3. A linear correlation was found between the prestroke CHA(2)DS(2)-VASc score and severity of stroke (P = .001). On multivariate analysis, CHA(2)DS(2)-VASc score correlated with severity of stroke (P = .041) and adverse functional outcome (mRS = 3) (P = .001). A logistic regression with the receiver operating characteristic graph procedure (C-statistics) evidenced an area under the curve of .60 (P = .0001) for severe stroke. Furthermore, a correlation was found between prestroke CHA(2)DS(2)-VASc score and lesion size. Conclusions: In patients with AF, in addition to the risk of stroke, a high CHA(2)DS(2)-VASc score was independently associated with both stroke severity at onset and disability and mortality at 90 days.

English

Journal of stroke and cerebrovascular diseases / National Stroke Association. - Englewood, Colo.

Englewood, Colo. : 2017

1052-3057

10.1016/J.JSTROKECEREBROVASDIS.2017.02.011

26 :6 (2017) , p. 1363-1368

000407017000036

28236595

https://doi.org/10.1016/J.JSTROKECEREBROVASDIS.2017.02.011

A1 Journal article 

Human medicine 

Publications with a UAntwerp address

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https://hdl.handle.net/10067/1452350151162165141