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 language | English |
|---|---|
| Pages (from-to) | 930-934 |
| Number of pages | 5 |
| Journal | Stroke |
| Volume | 42 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2011 Apr 1 |
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All Science Journal Classification (ASJC) codes
- Clinical Neurology
- Cardiology and Cardiovascular Medicine
- Advanced and Specialised Nursing
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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, Ji Hoe.
In: Stroke, Vol. 42, No. 4, 01.04.2011, p. 930-934.Research output: Contribution to journal › Article
TY - JOUR
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, Ji Hoe
PY - 2011/4/1
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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U2 - 10.1161/STROKEAHA.110.602987
DO - 10.1161/STROKEAHA.110.602987
M3 - Article
C2 - 21350200
AN - SCOPUS:79954606499
VL - 42
SP - 930
EP - 934
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 4
ER -