Increases in cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation

Young Dae Kim, Myoung Jin Cha, Jinkwon Kim, Dong Hyun Lee, Hye Sun Lee, Chung Mo Nam, Hyo Suk Nam, Jihoe Heo

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background and Purpose- The CHADS2 score is used for risk stratification of ischemic stroke in patients with nonvalvular atrial fibrillation and high CHADS2 scores are associated with increased risk of stroke. Most components of the CHADS2 score are also risk factors for atherosclerosis. Therefore, high CHADS2 scores can be associated with concomitant cerebral atherosclerosis and subsequently atherothrombotic stroke. The aim of this study was to determine whether there are differences in the presence and burden of concomitant cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation. Methods- We included 780 consecutive patients with nonvalvular atrial fibrillation who had undergone angiographic studies at index stroke between August 1994 and March 2010 in the present study. We investigated the relationships between the CHADS2 score and the presence, severity, and pattern of cerebral atherosclerosis and stroke mechanism. Results- Of the 780 patients, concomitant arterial stenosis (50%) was found in 231 patients (29.6%). The number of arteries with atherosclerosis increased as the CHADS2 score increased (P<0.001) as did the proportion of combined extracranial and intracranial atherosclerosis (P<0.001). Multivariate analyses showed that high risk based on the CHADS2 score was an independent predictor of concomitant cerebral atherosclerosis (OR, 3.121; 95% CI, 1.770 to 5.504) and the presence of proximal stenosis at the symptomatic artery (OR, 3.043; 95% CI, 1.458 to 6.350). Conclusions- The CHADS2 score can predict the presence of concomitant cerebral artery atherosclerosis. Increased risk of stroke in patients with high CHADS2 scores may be partly explained by increased frequency and burden of cerebral atherosclerosis.

Original languageEnglish
Pages (from-to)930-934
Number of pages5
JournalStroke
Volume42
Issue number4
DOIs
Publication statusPublished - 2011 Apr 1

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Intracranial Arteriosclerosis
Atrial Fibrillation
Stroke
Atherosclerosis
Pathologic Constriction
Arteries
Cerebral Arteries
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Kim, Young Dae ; Cha, Myoung Jin ; Kim, Jinkwon ; Lee, Dong Hyun ; Lee, Hye Sun ; Nam, Chung Mo ; Nam, Hyo Suk ; Heo, Jihoe. / Increases in cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation. In: Stroke. 2011 ; Vol. 42, No. 4. pp. 930-934.
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title = "Increases in cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation",
abstract = "Background and Purpose- The CHADS2 score is used for risk stratification of ischemic stroke in patients with nonvalvular atrial fibrillation and high CHADS2 scores are associated with increased risk of stroke. Most components of the CHADS2 score are also risk factors for atherosclerosis. Therefore, high CHADS2 scores can be associated with concomitant cerebral atherosclerosis and subsequently atherothrombotic stroke. The aim of this study was to determine whether there are differences in the presence and burden of concomitant cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation. Methods- We included 780 consecutive patients with nonvalvular atrial fibrillation who had undergone angiographic studies at index stroke between August 1994 and March 2010 in the present study. We investigated the relationships between the CHADS2 score and the presence, severity, and pattern of cerebral atherosclerosis and stroke mechanism. Results- Of the 780 patients, concomitant arterial stenosis (50{\%}) was found in 231 patients (29.6{\%}). The number of arteries with atherosclerosis increased as the CHADS2 score increased (P<0.001) as did the proportion of combined extracranial and intracranial atherosclerosis (P<0.001). Multivariate analyses showed that high risk based on the CHADS2 score was an independent predictor of concomitant cerebral atherosclerosis (OR, 3.121; 95{\%} CI, 1.770 to 5.504) and the presence of proximal stenosis at the symptomatic artery (OR, 3.043; 95{\%} CI, 1.458 to 6.350). Conclusions- The CHADS2 score can predict the presence of concomitant cerebral artery atherosclerosis. Increased risk of stroke in patients with high CHADS2 scores may be partly explained by increased frequency and burden of cerebral atherosclerosis.",
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Increases in cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation. / Kim, Young Dae; Cha, Myoung Jin; Kim, Jinkwon; Lee, Dong Hyun; Lee, Hye Sun; Nam, Chung Mo; Nam, Hyo Suk; Heo, Jihoe.

In: Stroke, Vol. 42, No. 4, 01.04.2011, p. 930-934.

Research output: Contribution to journalArticle

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T1 - Increases in cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation

AU - Kim, Young Dae

AU - Cha, Myoung Jin

AU - Kim, Jinkwon

AU - Lee, Dong Hyun

AU - Lee, Hye Sun

AU - Nam, Chung Mo

AU - Nam, Hyo Suk

AU - Heo, Jihoe

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Y1 - 2011/4/1

N2 - Background and Purpose- The CHADS2 score is used for risk stratification of ischemic stroke in patients with nonvalvular atrial fibrillation and high CHADS2 scores are associated with increased risk of stroke. Most components of the CHADS2 score are also risk factors for atherosclerosis. Therefore, high CHADS2 scores can be associated with concomitant cerebral atherosclerosis and subsequently atherothrombotic stroke. The aim of this study was to determine whether there are differences in the presence and burden of concomitant cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation. Methods- We included 780 consecutive patients with nonvalvular atrial fibrillation who had undergone angiographic studies at index stroke between August 1994 and March 2010 in the present study. We investigated the relationships between the CHADS2 score and the presence, severity, and pattern of cerebral atherosclerosis and stroke mechanism. Results- Of the 780 patients, concomitant arterial stenosis (50%) was found in 231 patients (29.6%). The number of arteries with atherosclerosis increased as the CHADS2 score increased (P<0.001) as did the proportion of combined extracranial and intracranial atherosclerosis (P<0.001). Multivariate analyses showed that high risk based on the CHADS2 score was an independent predictor of concomitant cerebral atherosclerosis (OR, 3.121; 95% CI, 1.770 to 5.504) and the presence of proximal stenosis at the symptomatic artery (OR, 3.043; 95% CI, 1.458 to 6.350). Conclusions- The CHADS2 score can predict the presence of concomitant cerebral artery atherosclerosis. Increased risk of stroke in patients with high CHADS2 scores may be partly explained by increased frequency and burden of cerebral atherosclerosis.

AB - Background and Purpose- The CHADS2 score is used for risk stratification of ischemic stroke in patients with nonvalvular atrial fibrillation and high CHADS2 scores are associated with increased risk of stroke. Most components of the CHADS2 score are also risk factors for atherosclerosis. Therefore, high CHADS2 scores can be associated with concomitant cerebral atherosclerosis and subsequently atherothrombotic stroke. The aim of this study was to determine whether there are differences in the presence and burden of concomitant cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation. Methods- We included 780 consecutive patients with nonvalvular atrial fibrillation who had undergone angiographic studies at index stroke between August 1994 and March 2010 in the present study. We investigated the relationships between the CHADS2 score and the presence, severity, and pattern of cerebral atherosclerosis and stroke mechanism. Results- Of the 780 patients, concomitant arterial stenosis (50%) was found in 231 patients (29.6%). The number of arteries with atherosclerosis increased as the CHADS2 score increased (P<0.001) as did the proportion of combined extracranial and intracranial atherosclerosis (P<0.001). Multivariate analyses showed that high risk based on the CHADS2 score was an independent predictor of concomitant cerebral atherosclerosis (OR, 3.121; 95% CI, 1.770 to 5.504) and the presence of proximal stenosis at the symptomatic artery (OR, 3.043; 95% CI, 1.458 to 6.350). Conclusions- The CHADS2 score can predict the presence of concomitant cerebral artery atherosclerosis. Increased risk of stroke in patients with high CHADS2 scores may be partly explained by increased frequency and burden of cerebral atherosclerosis.

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