CHADS(2), CHA(2)DS(2)-VASc, ATRIA, and Essen stroke risk scores in stroke with atrial fibrillation A nationwide multicenter registry study
- 주제(키워드) ATRIA score , atrial fibrillation , CHA(2)DS(2)-VASc score , CHADS(2) score , secondary prevention , stroke
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Yu, Inwu; Chung, Jong-Won; Bang, Oh Young; Kim, Geong-Moon; Seo, Woo-Keun] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Neurol, Seoul, South Korea; [Song, Tae-Jin] Seoul Hosp Ewha Womans Univ, Coll Med, Dept Neurol, Seoul, South Korea; [Kim, Bum Joon] Asan Med Ctr, Stroke Ctr, Dept Neurol, Seoul, South Korea; [Heo, Sung Hyuk] Kyung Hee Univ, Coll Med, Dept Neurol, Seoul, South Korea; [Jung, Jin-Man] Korea Univ, Coll Med, Ansan Hosp, Dept Neurol, Ansan, Kyungki Do, South Korea; [Oh, Kyung-Mi; Kim, Chi Kyung] Korea Univ, Guro Hosp, Dept Neurol, Seoul, South Korea; [Yu, Sungwook] Korea Univ, Coll Med, Anam Hosp, Dept Neurol, Seoul, South Korea; [Park, Kwang Yeol] Chung Ang Univ, Coll Med, Dept Neurol, Seoul, South Korea; [Kim, Jeong-Min] Seoul Natl Univ Hosp, Dept Neurol, Seoul, South Korea; [Park, Jong-Ho] Hanyang Univ, Coll Med, Myongji Hosp, Dept Neurol, Goyang, South Korea; [Choi, Jay Chol] Jeju Natl Univ, Dept Neurol, Jeju, South Korea; [Park, Man-Seok; Kim, Joon-Tae] Chonnam Natl Univ Hosp, Dept Neurol, Gwangju, South Korea; [Hwang, Yang-Ha] Kyungpook Natl Univ, Sch Med & Hosp, Cerebrovasc Ctr, Dept Neurol, Daegu, South Korea; [Kim, Yong-Jae] Catholic Univ Korea, Eunpyeong St Marys Hosp, Dept Neurol, Seoul, South Korea; [Kim, Seonwoo; Woo, Sook Young; Cho, Hyun] Samsung Med Ctr, Stat & Data Ctr, Seoul, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 LIPPINCOTT WILLIAMS & WILKINS
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000181403
- 본문언어 영어
- Published As http://dx.doi.org/10.1097/MD.0000000000024000
초록/요약
The performance of scoring systems for risk stratification in patients with atrial fibrillation (AF) was not validated well in patients with stroke. The purpose of this study was to evaluate whether the risk scoring systems predict vascular outcomes in stroke patients with AF. Data were obtained from a nationwide multicenter registry for acute stroke with AF from January 1, 2013, to December 31, 2015. We investigated the predictive power of the CHADS(2), CHA(2)DS(2)-VASc, ATRIA, and Essen stroke scores in stroke patients with AF. The subjects were further stratified into groups according to treatment with or without oral anticoagulants (OACs). A total of 3112 stroke with AF subjects were included. The rate of recurrent ischemic stroke and any stroke were not associated with the CHADS(2), CHA(2)DS(2)-VASc, ATRIA, and Essen stroke risk scores. The risks of death and major adverse cerebrovascular and cardiovascular events (MACEs) increased sequentially with the increase of each risk score in OAC group. (the range of C-index 0.544-0.558 for recurrent ischemic stroke; 0.523-0.537 for any stroke; 0.580-0.597 for death; 0.564-0.583 for MACEs). However, in the group treated with OACs, all risk scores were significantly associated with the risk of MACEs. The C-statistics of the 4 scoring systems were 0.544 to 0.558, 0.523 to 0.537, 0.580 to 0.597, 0.564 to 0.583, respectively, for recurrent ischemic stroke, any stroke, death, and MACEs. The performance of the CHADS(2), CHA(2)DS(2)-VASc, ATRIA, and Essen stroke risk scores for the prediction of recurrent stroke was unsatisfactory in stroke patients with AF whereas the performance for the prediction of recurrent stroke was not MACEs or death was good. A new risk stratification scheme that is specific for secondary stroke prevention in the AF population is needed.
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