Prestroke CHA(2)DS(2)-VASc Score and Severity of Acute Stroke in Patients with Atrial Fibrillation : Findings from RAF Study

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Acciarresi , M , Paciaroni , M , Agnelli , G , Falocci , N , Caso , V , Becattini , C , Marcheselli , S , Rueckert , C , Pezzini , A , Morotti , A , Costa , P , Padovani , A , Csiba , L , Szabo , L , Sohn , S-I , Tassinari , T , Abdul-Rahim , A H , Michel , P , Cordier , M , Vanacker , P , Remillard , S , Alberti , A , Venti , M , D'Amore , C , Scoditti , U , Denti , L , Orlandi , G , Chiti , A , Gialdini , G , Bovi , P , Carletti , M , Rigatelli , A , Putaala , J , Tatlisumak , T , Masotti , L , Lorenzini , G , Tassi , R , Guideri , F , Martini , G , Tsivgoulis , G , Vadikolias , K , Liantinioti , C , Corea , F , Del Sette , M , Ageno , W , De Lodovici , M L , Bono , G , Baldi , A , D'Anna , S , Sacco , S , Carolei , A , Tiseo , C , Imberti , D , Zabzuni , D , Doronin , B , Volodina , V , Consoli , D , Galati , F , Pieroni , A , Toni , D , Monaco , S , Baronello , M M , Barlinn , K , Pallesen , L-P , Kepplinger , J , Bodechtel , U , Gerber , J , Deleu , D , Melikyan , G , Ibrahim , F , Akhtar , N , Mosconi , M G & Lees , K R 2017 , ' Prestroke CHA(2)DS(2)-VASc Score and Severity of Acute Stroke in Patients with Atrial Fibrillation : Findings from RAF Study ' , Journal of Stroke & Cerebrovascular Diseases , vol. 26 , no. 6 , pp. 1363-1368 . https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.02.011

Title: Prestroke CHA(2)DS(2)-VASc Score and Severity of Acute Stroke in Patients with Atrial Fibrillation : Findings from RAF Study
Author: 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; Remillard, Suzette; Alberti, Andrea; Venti, Michele; D'Amore, Cataldo; Scoditti, Umberto; Denti, Licia; Orlandi, Giovanni; Chiti, Alberto; Gialdini, Gino; Bovi, Paolo; Carletti, Monica; Rigatelli, Alberto; Putaala, Jukka; Tatlisumak, Turgut; Masotti, Luca; Lorenzini, Gianni; Tassi, Rossana; Guideri, Francesca; Martini, Giuseppe; Tsivgoulis, Georgios; Vadikolias, Kostantinos; Liantinioti, Chrissoula; Corea, Francesco; Del Sette, Massimo; Ageno, Walter; De Lodovici, Maria Luisa; Bono, Giorgio; Baldi, Antonio; D'Anna, Sebastiano; Sacco, Simona; Carolei, Antonio; Tiseo, Cindy; Imberti, Davide; Zabzuni, Dorjan; Doronin, Boris; Volodina, Vera; Consoli, Domenico; Galati, Franco; Pieroni, Alessio; Toni, Danilo; Monaco, Serena; Baronello, Mario Maimone; Barlinn, Kristian; Pallesen, Lars-Peder; Kepplinger, Jessica; Bodechtel, Ulf; Gerber, Johannes; Deleu, Dirk; Melikyan, Gayane; Ibrahim, Faisal; Akhtar, Naveed; Mosconi, Maria Giulia; Lees, Kennedy R.
Contributor: University of Helsinki, Neurologian yksikkö
University of Helsinki, Neurologian yksikkö
Date: 2017-06
Language: eng
Number of pages: 6
Belongs to series: Journal of Stroke & Cerebrovascular Diseases
ISSN: 1052-3057
URI: http://hdl.handle.net/10138/297899
Abstract: 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.
Subject: Ischemic stroke
CHA(2)DS(2)-VASc score
severity
outcome
atrial fibrillation
scores
ACUTE ISCHEMIC-STROKE
ARTERIAL TERRITORIES
HUMAN BRAIN
OUTCOMES
CHADS(2)
3112 Neurosciences
3124 Neurology and psychiatry
3121 General medicine, internal medicine and other clinical medicine
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