CHA2DS2-VASc score in acute ischemic stroke with atrial fibrillation: results from the Clinical Research Collaboration for Stroke in Korea

Hak Loh Lee, Joon Tae Kim, Ji Sung Lee, Beom Joon Kim, Jong Moo Park, Kyusik Kang, Soo Joo Lee, Jae Guk Kim, Jae Kwan Cha, Dae Hyun Kim, Tai Hwan Park, Sang Soon Park, Kyung Bok Lee, Jun Lee, Keun Sik Hong, Yong Jin Cho, Hong Kyun Park, Byung Chul Lee, Kyung Ho Yu, Mi Sun OhDong Eog Kim, Wi Sun Ryu, Jay Chol Choi, Jee Hyun Kwon, Wook Joo Kim, Dong Ick Shin, Sung Il Sohn, Jeong Ho Hong, Man Seok Park, Kang Ho Choi, Ki Hyun Cho, Juneyoung Lee, Hee Joon Bae

Research output: Contribution to journalArticlepeer-review

Abstract

We investigated a multicenter registry to identify estimated event rates according to CHA2DS2-VASc scores in patients with acute ischemic stroke (AIS) and atrial fibrillation (AF). The additional effectiveness of antiplatelets (APs) plus oral anticoagulants (OACs) compared with OACs alone considering the CHA2DS2-VASc scores was also explored. This study retrospectively analyzed a multicenter stroke registry between Jan 2011 and Nov 2017, identifying patients with acute ischemic stroke with AF. The primary outcome event was a composite of recurrent stroke, myocardial infarction, and all-cause mortality within 1 year. A total of 7395 patients (age, 73 ± 10 years; men, 54.2%) were analyzed. The primary outcome events at one year ranged from 5.99% (95% CI 3.21–8.77) for a CHA2DS2-VASc score of 0 points to 30.45% (95% CI 24.93–35.97) for 7 or more points. After adjustments for covariates, 1-point increases in the CHA2DS2-VASc score consistently increased the risk of primary outcome events (aHR 1.10 [1.06–1.15]) at 1-year. Among OAC-treated patients at discharge (n = 5500), those treated with OAC + AP (vs. OAC alone) were more likely to experience vascular events, though among patients with a CHA2DS2-VASc score of 5 or higher, the risk of primary outcome in the OAC + AP group was comparable to that in the OAC alone group (Pint = 0.01). Our study found that there were significant associations of increasing CHA2DS2-VASc scores with the increasing risk of vascular events at 1-year in AIS with AF. Further study would be warranted.

Original languageEnglish
Article number793
JournalScientific Reports
Volume11
Issue number1
DOIs
StatePublished - Dec 2021

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