CHA2DS2-VASc score in acute ischemic stroke with atrial fibrillation: results from the Clinical Research Collaboration for Stroke in Korea

We investigated a multicenter registry to identify estimated event rates according to CHA2DS2-VASc scores in patients with acute ischemic stroke (AIS) and atrial fibrillation (AF). The additional effectiveness of antiplatelets (APs) plus oral anticoagulants (OACs) compared with OACs alone considerin...

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Veröffentlicht in:Scientific reports 2021-01, Vol.11 (1), p.793-793, Article 793
Hauptverfasser: Lee, Hak-Loh, Kim, Joon-Tae, Lee, Ji Sung, Kim, Beom Joon, Park, Jong-Moo, Kang, Kyusik, Lee, Soo Joo, Kim, Jae Guk, Cha, Jae-Kwan, Kim, Dae-Hyun, Park, Tai Hwan, Park, Sang-Soon, Lee, Kyung Bok, Lee, Jun, Hong, Keun-Sik, Cho, Yong-Jin, Park, Hong-Kyun, Lee, Byung-Chul, Yu, Kyung-Ho, Oh, Mi Sun, Kim, Dong-Eog, Ryu, Wi-Sun, Choi, Jay Chol, Kwon, Jee-Hyun, Kim, Wook-Joo, Shin, Dong-Ick, Sohn, Sung Il, Hong, Jeong-Ho, Park, Man-Seok, Choi, Kang-Ho, Cho, Ki-Hyun, Lee, Juneyoung, Bae, Hee-Joon
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Sprache:eng
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Zusammenfassung:We investigated a multicenter registry to identify estimated event rates according to CHA2DS2-VASc scores in patients with acute ischemic stroke (AIS) and atrial fibrillation (AF). The additional effectiveness of antiplatelets (APs) plus oral anticoagulants (OACs) compared with OACs alone considering the CHA2DS2-VASc scores was also explored. This study retrospectively analyzed a multicenter stroke registry between Jan 2011 and Nov 2017, identifying patients with acute ischemic stroke with AF. The primary outcome event was a composite of recurrent stroke, myocardial infarction, and all-cause mortality within 1 year. A total of 7395 patients (age, 73 ± 10 years; men, 54.2%) were analyzed. The primary outcome events at one year ranged from 5.99% (95% CI 3.21–8.77) for a CHA2DS2-VASc score of 0 points to 30.45% (95% CI 24.93–35.97) for 7 or more points. After adjustments for covariates, 1-point increases in the CHA2DS2-VASc score consistently increased the risk of primary outcome events (aHR 1.10 [1.06–1.15]) at 1-year. Among OAC-treated patients at discharge (n = 5500), those treated with OAC + AP (vs. OAC alone) were more likely to experience vascular events, though among patients with a CHA2DS2-VASc score of 5 or higher, the risk of primary outcome in the OAC + AP group was comparable to that in the OAC alone group (P int  = 0.01). Our study found that there were significant associations of increasing CHA2DS2-VASc scores with the increasing risk of vascular events at 1-year in AIS with AF. Further study would be warranted.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-020-80874-1