In:
Cerebrovascular Diseases, S. Karger AG, Vol. 45, No. 3-4 ( 2018), p. 170-179
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 We aimed to clarify associations between pre-admission risk scores (CHADS 〈 sub 〉 2 〈 /sub 〉 , CHA 〈 sub 〉 2 〈 /sub 〉 DS 〈 sub 〉 2 〈 /sub 〉 -VASc, and HAS-BLED) and 2-year clinical outcomes in ischemic stroke or transient ischemic attack (TIA) patients with non-valvular atrial fibrillation (NVAF) using a prospective, multicenter, observational registry. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 From 18 Japanese stroke centers, ischemic stroke or TIA patients with NVAF hospitalized within 7 days after onset were enrolled. Outcome measures were defined as death/disability (modified Rankin Scale score ≥3) at 2 years, 2-year mortality, and ischemic or hemorrhagic events within 2 years. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 1,192 patients with NVAF (527 women; mean age, 78 ± 10 years), including 1,141 ischemic stroke and 51 TIA, were analyzed. Rates of death/disability, mortality, and ischemic or hemorrhagic events increased significantly with increasing pre-admission CHADS 〈 sub 〉 2 〈 /sub 〉 ( 〈 i 〉 p 〈 /i 〉 for trend & #x3c;0.001 for death/disability and mortality, 〈 i 〉 p 〈 /i 〉 for trend = 0.024 for events), CHA 〈 sub 〉 2 〈 /sub 〉 DS 〈 sub 〉 2 〈 /sub 〉 -VASc ( 〈 i 〉 p 〈 /i 〉 for trend & #x3c;0.001 for all), and HAS-BLED ( 〈 i 〉 p 〈 /i 〉 for trend = 0.004 for death/disability, 〈 i 〉 p 〈 /i 〉 for trend & #x3c;0.001 for mortality, 〈 i 〉 p 〈 /i 〉 for trend = 0.024 for events) scores. Pre-admission CHADS 〈 sub 〉 2 〈 /sub 〉 (OR per 1 point, 1.52; 95% CI 1.35–1.71; 〈 i 〉 p 〈 /i 〉 & #x3c;0.001 for death/disability; hazard ratio (HR) per 1 point, 1.23; 95% CI 1.12–1.35; 〈 i 〉 p 〈 /i 〉 & #x3c;0.001 for mortality; HR per 1 point, 1.14; 95% CI 1.02–1.26; 〈 i 〉 p 〈 /i 〉 = 0.016 for events), CHA 〈 sub 〉 2 〈 /sub 〉 DS 〈 sub 〉 2 〈 /sub 〉 -VASc (1.55, 1.41–1.72, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; 1.21, 1.12–1.30, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; 1.17, 1.07–1.27, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; respectively), and HAS-BLED (1.33, 1.17–1.52, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; 1.23, 1.10–1.38, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; 1.18, 1.05–1.34, 〈 i 〉 p 〈 /i 〉 = 0.008; respectively) scores were independently associated with all outcome measures. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 In ischemic stroke or TIA patients with NVAF, all pre-admission risk scores were independently associated with death/disability at 2 years and 2-year mortality, as well as ischemic or hemorrhagic events within 2 years.
Type of Medium:
Online Resource
ISSN:
1015-9770
,
1421-9786
Language:
English
Publisher:
S. Karger AG
Publication Date:
2018
detail.hit.zdb_id:
1482069-9
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