Early neurological outcomes according to CHADS 2 score in stroke patients with non-valvular atrial fibrillation

H. J. Hong, Y. D. Kim, M. J. Cha, J. Kim, D. H. Lee, H. S. Lee, C. M. Nam, H. S. Nam, Jihoe Heo

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background and purpose: A higher CHADS 2 score or CHA 2DS 2-VASc score is associated with an increased risk of ischaemic stroke in patients with non-valvular atrial fibrillation (NVAF). However, there are no data regarding early neurological outcomes after stroke according to the risk levels. Methods: In this study, a total of 649 stroke patients with NVAF were enrolled and categorized into three groups: low-risk (CHADS 2 score of 0-1), moderate-risk (CHADS 2 score 2-3), or high-risk group (CHADS 2 score ≥4). CHA 2DS 2-VASc score was divided into four groups including 0-1, 2-3, 4-5, and ≥6. We investigated whether there were differences in initial stroke severity, early neurological outcome, and infarct size according to CHADS 2 score or CHA 2DS 2-VASc score in stroke patients with NVAF. Results: The initial National Institutes of Health Stroke Scale (NIHSS) score was highest in high-risk group [9.5, interquartile range (IQR) 4-18], followed by moderate-risk (8, IQR 2-17) and low-risk group (6, IQR 2-15) (P=0.012). Likewise, initial stroke severity increased in a positive fashion with increasing the CHA 2DS 2-VASc score. During hospitalization, those in the high-risk group or higher CHA 2DS 2-VASc score had less improvement in their NIHSS score. Furthermore, early neurological deterioration (END) developed more frequently as CHADS 2 score or CHA 2DS 2-VASc score increased. Multivariate analysis showed being in the high-risk group was independently associated with END (OR 2.129, 95% CI 1.013-4.477). Conclusions: Our data indicate that patients with NVAF and higher CHADS 2 score or CHA 2DS 2-VASc score are more likely to develop severe stroke and a worse clinical course is expected in these patients after stroke presentation.

Original languageEnglish
Pages (from-to)284-290
Number of pages7
JournalEuropean Journal of Neurology
Volume19
Issue number2
DOIs
Publication statusPublished - 2012 Feb 1

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Atrial Fibrillation
Stroke
National Institutes of Health (U.S.)
Hospitalization
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Hong, H. J. ; Kim, Y. D. ; Cha, M. J. ; Kim, J. ; Lee, D. H. ; Lee, H. S. ; Nam, C. M. ; Nam, H. S. ; Heo, Jihoe. / Early neurological outcomes according to CHADS 2 score in stroke patients with non-valvular atrial fibrillation. In: European Journal of Neurology. 2012 ; Vol. 19, No. 2. pp. 284-290.
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abstract = "Background and purpose: A higher CHADS 2 score or CHA 2DS 2-VASc score is associated with an increased risk of ischaemic stroke in patients with non-valvular atrial fibrillation (NVAF). However, there are no data regarding early neurological outcomes after stroke according to the risk levels. Methods: In this study, a total of 649 stroke patients with NVAF were enrolled and categorized into three groups: low-risk (CHADS 2 score of 0-1), moderate-risk (CHADS 2 score 2-3), or high-risk group (CHADS 2 score ≥4). CHA 2DS 2-VASc score was divided into four groups including 0-1, 2-3, 4-5, and ≥6. We investigated whether there were differences in initial stroke severity, early neurological outcome, and infarct size according to CHADS 2 score or CHA 2DS 2-VASc score in stroke patients with NVAF. Results: The initial National Institutes of Health Stroke Scale (NIHSS) score was highest in high-risk group [9.5, interquartile range (IQR) 4-18], followed by moderate-risk (8, IQR 2-17) and low-risk group (6, IQR 2-15) (P=0.012). Likewise, initial stroke severity increased in a positive fashion with increasing the CHA 2DS 2-VASc score. During hospitalization, those in the high-risk group or higher CHA 2DS 2-VASc score had less improvement in their NIHSS score. Furthermore, early neurological deterioration (END) developed more frequently as CHADS 2 score or CHA 2DS 2-VASc score increased. Multivariate analysis showed being in the high-risk group was independently associated with END (OR 2.129, 95{\%} CI 1.013-4.477). Conclusions: Our data indicate that patients with NVAF and higher CHADS 2 score or CHA 2DS 2-VASc score are more likely to develop severe stroke and a worse clinical course is expected in these patients after stroke presentation.",
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Early neurological outcomes according to CHADS 2 score in stroke patients with non-valvular atrial fibrillation. / Hong, H. J.; Kim, Y. D.; Cha, M. J.; Kim, J.; Lee, D. H.; Lee, H. S.; Nam, C. M.; Nam, H. S.; Heo, Jihoe.

In: European Journal of Neurology, Vol. 19, No. 2, 01.02.2012, p. 284-290.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Early neurological outcomes according to CHADS 2 score in stroke patients with non-valvular atrial fibrillation

AU - Hong, H. J.

AU - Kim, Y. D.

AU - Cha, M. J.

AU - Kim, J.

AU - Lee, D. H.

AU - Lee, H. S.

AU - Nam, C. M.

AU - Nam, H. S.

AU - Heo, Jihoe

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N2 - Background and purpose: A higher CHADS 2 score or CHA 2DS 2-VASc score is associated with an increased risk of ischaemic stroke in patients with non-valvular atrial fibrillation (NVAF). However, there are no data regarding early neurological outcomes after stroke according to the risk levels. Methods: In this study, a total of 649 stroke patients with NVAF were enrolled and categorized into three groups: low-risk (CHADS 2 score of 0-1), moderate-risk (CHADS 2 score 2-3), or high-risk group (CHADS 2 score ≥4). CHA 2DS 2-VASc score was divided into four groups including 0-1, 2-3, 4-5, and ≥6. We investigated whether there were differences in initial stroke severity, early neurological outcome, and infarct size according to CHADS 2 score or CHA 2DS 2-VASc score in stroke patients with NVAF. Results: The initial National Institutes of Health Stroke Scale (NIHSS) score was highest in high-risk group [9.5, interquartile range (IQR) 4-18], followed by moderate-risk (8, IQR 2-17) and low-risk group (6, IQR 2-15) (P=0.012). Likewise, initial stroke severity increased in a positive fashion with increasing the CHA 2DS 2-VASc score. During hospitalization, those in the high-risk group or higher CHA 2DS 2-VASc score had less improvement in their NIHSS score. Furthermore, early neurological deterioration (END) developed more frequently as CHADS 2 score or CHA 2DS 2-VASc score increased. Multivariate analysis showed being in the high-risk group was independently associated with END (OR 2.129, 95% CI 1.013-4.477). Conclusions: Our data indicate that patients with NVAF and higher CHADS 2 score or CHA 2DS 2-VASc score are more likely to develop severe stroke and a worse clinical course is expected in these patients after stroke presentation.

AB - Background and purpose: A higher CHADS 2 score or CHA 2DS 2-VASc score is associated with an increased risk of ischaemic stroke in patients with non-valvular atrial fibrillation (NVAF). However, there are no data regarding early neurological outcomes after stroke according to the risk levels. Methods: In this study, a total of 649 stroke patients with NVAF were enrolled and categorized into three groups: low-risk (CHADS 2 score of 0-1), moderate-risk (CHADS 2 score 2-3), or high-risk group (CHADS 2 score ≥4). CHA 2DS 2-VASc score was divided into four groups including 0-1, 2-3, 4-5, and ≥6. We investigated whether there were differences in initial stroke severity, early neurological outcome, and infarct size according to CHADS 2 score or CHA 2DS 2-VASc score in stroke patients with NVAF. Results: The initial National Institutes of Health Stroke Scale (NIHSS) score was highest in high-risk group [9.5, interquartile range (IQR) 4-18], followed by moderate-risk (8, IQR 2-17) and low-risk group (6, IQR 2-15) (P=0.012). Likewise, initial stroke severity increased in a positive fashion with increasing the CHA 2DS 2-VASc score. During hospitalization, those in the high-risk group or higher CHA 2DS 2-VASc score had less improvement in their NIHSS score. Furthermore, early neurological deterioration (END) developed more frequently as CHADS 2 score or CHA 2DS 2-VASc score increased. Multivariate analysis showed being in the high-risk group was independently associated with END (OR 2.129, 95% CI 1.013-4.477). Conclusions: Our data indicate that patients with NVAF and higher CHADS 2 score or CHA 2DS 2-VASc score are more likely to develop severe stroke and a worse clinical course is expected in these patients after stroke presentation.

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