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, J. H. Heo

Research output: Contribution to journalArticle

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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.

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, J. H. / 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, J. H.

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, J. H.

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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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