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Byline: Nazli. Bulbul, Serkan. Demir, Suat. Özkan, Cesur. Samanci, Murat. Atmaca, Didem. Çelik, Ercan. Köse, Funda. Alparslan, Aysenur. Altiner, Selma. Ari, Ceyda. Dogan, Cansu. Yavuz, Zeynep. Arslan, Okan. Aksahin, Mehmet. [...]

Byline: Esme. Ekizoglu, Murat. Atmaca, Cagla. Cinar-Balcioglu, Nilufer. Yesilot, Oguzhan. Coban Background and Aims: Cryptogenic ischemic strokes (CIS) are treated with antiplatelets for stroke prevention in routine clinical practice. The [...]

Background and Aims: Cryptogenic ischemic strokes (CIS) are treated with antiplatelets for stroke prevention in routine clinical practice. The objective of this study was to investigate whether the CHADS2 and CHA2DS2-VASc scores may be used to identify the patients with CIS at higher risk of ischemic stroke despite antiplatelet therapy.Material and Methods: We calculated CHADS2 and CHA2DS2-VASc scores in patients with first ever CIS; those previously managed with antiplatelets (AP group) and in those without antiplatelets (non-AP group), using the prospectively recorded data of the Istanbul Medical School Stroke Registry from 1996-2014.Results: Of the 4466 IS patients, 886 patients with first ever IS had complete data for score calculation. Seventy-five (39 women) of them were diagnosed with CIS. CHADS2 and CHA2DS2-VASc scores were significantly higher in the AP group of 19 patients in comparison to the non-AP group of 56 patients (P = 0.005 and P = 0.009, respectively). ROC curve analyses showed an area under curve (AUC) of 0.705 (CI: 0.57-0.84; P = 0.008) for CHADS2 score ≥3 and AUC of 0.699 (CI: 0.57-0.82; P = 0.01) for CHA2DS2-VASc score ≥4. Vascular diseases were more frequent in the AP group and these patients were older than the patients in the non-AP group (P = 0.025, P = 0.024; respectively).Conclusions: CHA2DS2-VASc score ≥ 4 and CHADS2 score ≥3 may be used as a predictor of the occurrence of IS despite regular antiplatelet use and suggest an embolic source which will respond better to anticogulation. Our results support that CHADS2 and CHA2DS2-VASc scores may be useful to identify subgroups among patients with CIS for individualizing diagnostic approach, planning future workup and preventive treatment. [ABSTRACT FROM AUTHOR]

Background and Aims: Cryptogenic ischemic strokes (CIS) are treated with antiplatelets for stroke prevention in routine clinical practice. The objective of this study was to investigate whether the CHADS 2 and CHA 2 DS 2 -VASc scores may be used to identify the patients with CIS at higher risk of ischemic stroke despite antiplatelet therapy., Material and Methods: We calculated CHADS 2 and CHA 2 DS 2 -VASc scores in patients with first ever CIS; those previously managed with antiplatelets (AP group) and in those without antiplatelets (non-AP group), using the prospectively recorded data of the Istanbul Medical School Stroke Registry from 1996-2014., Results: Of the 4466 IS patients, 886 patients with first ever IS had complete data for score calculation. Seventy-five (39 women) of them were diagnosed with CIS. CHADS 2 and CHA 2 DS 2 -VASc scores were significantly higher in the AP group of 19 patients in comparison to the non-AP group of 56 patients (P = 0.005 and P = 0.009, respectively). ROC curve analyses showed an area under curve (AUC) of 0.705 (CI: 0.57-0.84; P = 0.008) for CHADS 2 score ≥3 and AUC of 0.699 (CI: 0.57-0.82; P = 0.01) for CHA 2 DS 2 -VASc score ≥4. Vascular diseases were more frequent in the AP group and these patients were older than the patients in the non-AP group (P = 0.025, P = 0.024; respectively)., Conclusions: CHA 2 DS 2 -VASc score ≥ 4 and CHADS 2 score ≥3 may be used as a predictor of the occurrence of IS despite regular antiplatelet use and suggest an embolic source which will respond better to anticogulation. Our results support that CHADS 2 and CHA 2 DS 2 -VASc scores may be useful to identify subgroups among patients with CIS for individualizing diagnostic approach, planning future workup and preventive treatment., Competing Interests: None