TY - JOUR
T1 - Associations between Pre-Admission Risk Scores and Two-Year Clinical Outcomes in Ischemic Stroke or Transient Ischemic Attack Patients with Non-Valvular Atrial Fibrillation
AU - Tokunaga, Keisuke
AU - Yamagami, Hiroshi
AU - Koga, Masatoshi
AU - Todo, Kenichi
AU - Kimura, Kazumi
AU - Itabashi, Ryo
AU - Terasaki, Tadashi
AU - Shiokawa, Yoshiaki
AU - Kamiyama, Kenji
AU - Takizawa, Shunya
AU - Okuda, Satoshi
AU - Okada, Yasushi
AU - Kameda, Tomoaki
AU - Nagakane, Yoshinari
AU - Hasegawa, Yasuhiro
AU - Shibuya, Satoshi
AU - Ito, Yasuhiro
AU - Matsuoka, Hideki
AU - Takamatsu, Kazuhiro
AU - Nishiyama, Kazutoshi
AU - Kario, Kazuomi
AU - Yagita, Yoshiki
AU - Kitazono, Takanari
AU - Kinoshita, Naoto
AU - Takasugi, Junji
AU - Okata, Takuya
AU - Yoshimura, Sohei
AU - Sato, Shoichiro
AU - Arihiro, Shoji
AU - Toyoda, Kazunori
N1 - Publisher Copyright:
© 2018 S. Karger AG, Basel.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Background: We aimed to clarify associations between pre-admission risk scores (CHADS 2 , CHA 2 DS 2 -VASc, and HAS-BLED) and 2-year clinical outcomes in ischemic stroke or transient ischemic attack (TIA) patients with non-valvular atrial fibrillation (NVAF) using a prospective, multicenter, observational registry. Methods: From 18 Japanese stroke centers, ischemic stroke or TIA patients with NVAF hospitalized within 7 days after onset were enrolled. Outcome measures were defined as death/disability (modified Rankin Scale score ≥3) at 2 years, 2-year mortality, and ischemic or hemorrhagic events within 2 years. Results: A total of 1,192 patients with NVAF (527 women; mean age, 78 ± 10 years), including 1,141 ischemic stroke and 51 TIA, were analyzed. Rates of death/disability, mortality, and ischemic or hemorrhagic events increased significantly with increasing pre-admission CHADS 2 (p for trend <0.001 for death/disability and mortality, p for trend = 0.024 for events), CHA 2 DS 2 -VASc (p for trend <0.001 for all), and HAS-BLED (p for trend = 0.004 for death/disability, p for trend <0.001 for mortality, p for trend = 0.024 for events) scores. Pre-admission CHADS 2 (OR per 1 point, 1.52; 95% CI 1.35-1.71; p <0.001 for death/disability; hazard ratio (HR) per 1 point, 1.23; 95% CI 1.12-1.35; p <0.001 for mortality; HR per 1 point, 1.14; 95% CI 1.02-1.26; p = 0.016 for events), CHA 2 DS 2 -VASc (1.55, 1.41-1.72, p < 0.001; 1.21, 1.12-1.30, p < 0.001; 1.17, 1.07-1.27, p < 0.001; respectively), and HAS-BLED (1.33, 1.17-1.52, p < 0.001; 1.23, 1.10-1.38, p < 0.001; 1.18, 1.05-1.34, p = 0.008; respectively) scores were independently associated with all outcome measures. Conclusions: In ischemic stroke or TIA patients with NVAF, all pre-admission risk scores were independently associated with death/disability at 2 years and 2-year mortality, as well as ischemic or hemorrhagic events within 2 years.
AB - Background: We aimed to clarify associations between pre-admission risk scores (CHADS 2 , CHA 2 DS 2 -VASc, and HAS-BLED) and 2-year clinical outcomes in ischemic stroke or transient ischemic attack (TIA) patients with non-valvular atrial fibrillation (NVAF) using a prospective, multicenter, observational registry. Methods: From 18 Japanese stroke centers, ischemic stroke or TIA patients with NVAF hospitalized within 7 days after onset were enrolled. Outcome measures were defined as death/disability (modified Rankin Scale score ≥3) at 2 years, 2-year mortality, and ischemic or hemorrhagic events within 2 years. Results: A total of 1,192 patients with NVAF (527 women; mean age, 78 ± 10 years), including 1,141 ischemic stroke and 51 TIA, were analyzed. Rates of death/disability, mortality, and ischemic or hemorrhagic events increased significantly with increasing pre-admission CHADS 2 (p for trend <0.001 for death/disability and mortality, p for trend = 0.024 for events), CHA 2 DS 2 -VASc (p for trend <0.001 for all), and HAS-BLED (p for trend = 0.004 for death/disability, p for trend <0.001 for mortality, p for trend = 0.024 for events) scores. Pre-admission CHADS 2 (OR per 1 point, 1.52; 95% CI 1.35-1.71; p <0.001 for death/disability; hazard ratio (HR) per 1 point, 1.23; 95% CI 1.12-1.35; p <0.001 for mortality; HR per 1 point, 1.14; 95% CI 1.02-1.26; p = 0.016 for events), CHA 2 DS 2 -VASc (1.55, 1.41-1.72, p < 0.001; 1.21, 1.12-1.30, p < 0.001; 1.17, 1.07-1.27, p < 0.001; respectively), and HAS-BLED (1.33, 1.17-1.52, p < 0.001; 1.23, 1.10-1.38, p < 0.001; 1.18, 1.05-1.34, p = 0.008; respectively) scores were independently associated with all outcome measures. Conclusions: In ischemic stroke or TIA patients with NVAF, all pre-admission risk scores were independently associated with death/disability at 2 years and 2-year mortality, as well as ischemic or hemorrhagic events within 2 years.
KW - Atrial fibrillation
KW - Ischemic stroke
KW - Mortality
KW - Outcome
KW - Risk score
KW - Transient ischemic attack
UR - https://www.scopus.com/pages/publications/85045040550
U2 - 10.1159/000487896
DO - 10.1159/000487896
M3 - Article
C2 - 29597211
AN - SCOPUS:85045040550
SN - 1015-9770
VL - 45
SP - 170
EP - 179
JO - Cerebrovascular Diseases
JF - Cerebrovascular Diseases
IS - 3-4
ER -