1. Prestroke CHA 2 DS 2 -VASc Score and Severity of Acute Stroke in Patients with Atrial Fibrillation: Findings from RAF Study.
- Author
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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, Szabó L, Sohn SI, Tassinari T, Abdul-Rahim AH, 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 ML, 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 MM, Barlinn K, Pallesen LP, Kepplinger J, Bodechtel U, Gerber J, Deleu D, Melikyan G, Ibrahim F, Akhtar N, Mosconi MG, and Lees KR
- Subjects
- Aged, Aged, 80 and over, Area Under Curve, Asia, Atrial Fibrillation diagnosis, Atrial Fibrillation mortality, Chi-Square Distribution, Disability Evaluation, Europe, Female, Humans, Linear Models, Logistic Models, Magnetic Resonance Imaging, Male, Multivariate Analysis, Odds Ratio, Predictive Value of Tests, Prognosis, Prospective Studies, ROC Curve, Risk Assessment, Risk Factors, Severity of Illness Index, Stroke etiology, Stroke mortality, Time Factors, Tomography, X-Ray Computed, Atrial Fibrillation complications, Decision Support Techniques, Stroke diagnosis
- Abstract
Background and Purpose: The aim of this study was to investigate for a possible association between both prestroke CHA
2 DS2 -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 CHA2 DS2 -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 CHA2 DS2 -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 CHA2 DS2 -VASc score and severity of stroke (P = .001). On multivariate analysis, CHA2 DS2 -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 CHA2 DS2 -VASc score and lesion size., Conclusions: In patients with AF, in addition to the risk of stroke, a high CHA2 DS2 -VASc score was independently associated with both stroke severity at onset and disability and mortality at 90 days., (Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.)- Published
- 2017
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