Associations between Pre-Admission Risk Scores and Two-Year Clinical Outcomes in Ischemic Stroke or Transient Ischemic Attack Patients with Non-Valvular Atrial Fibrillation.

<bold><italic>Background:</italic></bold> We aimed to clarify associations between pre-admission risk scores (CHADS₂, CHA₂DS₂-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. <bold><italic>Methods:</italic></bold> 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. <bold><italic>Results:</italic></bold> 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 CHADS₂ (<italic>p</italic> for trend <0.001 for death/disability and mortality, <italic>p</italic> for trend = 0.024 for events), CHA₂DS₂-VASc (<italic>p</italic> for trend <0.001 for all), and HAS-BLED (<italic>p</italic> for trend = 0.004 for death/disability, <italic>p</italic> for trend <0.001 for mortality, <italic>p</italic> for trend = 0.024 for events) scores. Pre-admission CHADS₂ (OR per 1 point, 1.52; 95% CI 1.35–1.71; <italic>p</italic> <0.001 for death/disability; hazard ratio (HR) per 1 point, 1.23; 95% CI 1.12–1.35; <italic>p</italic> <0.001 for mortality; HR per 1 point, 1.14; 95% CI 1.02–1.26; <italic>p</italic> = 0.016 for events), CHA₂DS₂-VASc (1.55, 1.41–1.72, <italic>p</italic> < 0.001; 1.21, 1.12–1.30, <italic>p</italic> < 0.001; 1.17, 1.07–1.27, <italic>p</italic> < 0.001; respectively), and HAS-BLED (1.33, 1.17–1.52, <italic>p</italic> < 0.001; 1.23, 1.10–1.38, <italic>p </italic>< 0.001; 1.18, 1.05–1.34, <italic>p</italic> = 0.008; respectively) scores were independently associated with all outcome measures. <bold><italic>Conclusions:</italic></bold> 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. [ABSTRACT FROM AUTHOR]