1. CHADS2 Score/CHA2DS2-VASc Score and Major Artery Occlusion in Cardioembolic Stroke Patients with Nonvalvular Atrial Fibrillation
- Author
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Takeshi Hayashi, Norio Tanahashi, Yuito Nagamine, Takuya Fukuoka, Yasuko Ohe, Hiroyasu Sano, Yohsuke Horiuchi, Yuji Kato, Ichiro Deguchi, and Hajime Maruyama
- Subjects
Middle Cerebral Artery ,medicine.medical_specialty ,Myocardial Infarction ,Posterior cerebral artery ,Severity of Illness Index ,Internal medicine ,medicine.artery ,Atrial Fibrillation ,Occlusion ,medicine ,Anterior cerebral artery ,Basilar artery ,Humans ,Aged ,Retrospective Studies ,business.industry ,Incidence ,Magnetic Resonance Imaging ,Arterial occlusion ,Cerebral Angiography ,Neurology ,Basilar Artery ,Middle cerebral artery ,CHA2DS2–VASc score ,Cardiology ,Female ,Cerebral Arterial Diseases ,Internal carotid artery ,business ,Carotid Artery, Internal ,Magnetic Resonance Angiography - Abstract
Objective The associations between the CHADS2 score/ CHA2DS2-VASc score, and the presence of cerebral vessel occlusion on admission were examined in cardioembolic stroke patients with nonvalvular atrial fibrillation. Methods The subjects were 546 consecutive patients hospitalized between April 2007 and December 2012 with onset of cardioembolic stroke associated with nonvalvular atrial fibrillation within 24 h. The associations between the CHADS2 score/CHA2DS2-VASc score and the presence of occluded cerebral vessels on magnetic resonance angiography were evaluated retrospectively. Occluded cerebral vessels were classified into the internal carotid artery, middle cerebral artery (M1, M2), basilar artery, and other (anterior cerebral artery [A1], posterior cerebral artery [P1], vertebral artery). Results Major artery occlusion was seen in 52% of patients with CHADS2 score 0, 52% of patients with score 1, 57% with score 2, 75% with score 3, and 75% with score ≥4. As for the CHA2DS2-VASc score, major artery occlusion was seen in 62% of patients with score 0, 49% with score 1, 53% with score 2, 53% with score 3, 65% with score 4, 71% with score 5, and 82% with score ≥6. The incidence of concurrent major arterial occlusion increased as both scores rose. When classified by occluded blood vessel, the incidence of concurrent internal carotid artery occlusion increased as both the CHADS2 and CHA2DS2-VASc scores increased. Conclusion As the CHADS2 and CHA2DS2-VASs scores increased, the incidence of concurrent major arterial occlusion, particularly internal carotid artery occlusion, increased in patients with cardioembolic stroke associated with nonvalvular atrial fibrillation.
- Published
- 2014
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