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CHA2DS2–VASc score predicts short- and long-term outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis

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Abstract

The CHA2DS2–VASc score is a validated tool to assess the thromboembolic risk in patients with atrial fibrillation. Pre-stroke CHA2DS2–VASc score may predict outcome in patients with acute ischemic stroke (AIS) without atrial fibrillation. The aim of this study was to investigate if the pre-stroke CHA2DS2–VASc score is able to predict short- and long-term outcomes in AIS patients treated with intravenous thrombolysis (IVT). The study group consisted of 256 consecutive patients admitted to the Udine University Hospital with AIS and underwent IVT between January 2015 to March 2017. The pre-stroke CHA2DS2–VASc score for each patient was calculated from the collected baseline data. Patients were classified into three groups according to their pre-stroke CHA2DS2–VASc score: a score of 0 of 1, a score of 2 or 3 and a score above 3. Primary outcome measures were: rate of favorable outcome at 90-days and at 1-year, and mortality at 90-days and at 1-year. Data on functional outcome and mortality 1 year after stroke were collected in 165 patients (65% of the entire sample). Favorable outcome was defined as a modified Rankin Scale score ≤ 2. Compared with the CHA2DS2–VASc score 0–1 group, patients with higher CHA2DS2–VASc scores had a worse outcome and a higher mortality 3 months and 1 year after stroke. The diagnostic performance of the CHA2DS2–VASc score as judged with AUC-ROC was 0.70 (95% CI, 0.64–0.76; p < 0.001) for favorable outcome at 90-days, 0.78 (95% CI, 0.71–0.85; p < 0.001) for favorable outcome at 1-year, 0.71 (95% CI 0.61–0.79) for mortality at 90-days, 0.73 (95% CI 0.64–0.80; p < 0.001) for mortality at 1-year. Pre-stroke CHA2DS2–VASc score represents a good predictor for short- and long-term outcomes in AIS patients treated with IVT.

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Authors and Affiliations

  1. Stroke Unit, Department of Neurosciences, Udine University-Hospital, Udine, Italy

    Giovanni Merlino, Michele Rana, Sara Naliato, Iacopo Cancelli, Simone Lorenzut, Roberto Marinig & Roberto Eleopra

  2. Stroke Unit, Department of Neurosciences, S. Maria della Misericordia University Hospital, Piazzale S. Maria della Misericordia 15, 33100, Udine, Italy

    Giovanni Merlino

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  1. Giovanni Merlino
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  2. Michele Rana
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  3. Sara Naliato
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Correspondence to Giovanni Merlino.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Merlino, G., Rana, M., Naliato, S. et al. CHA2DS2–VASc score predicts short- and long-term outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis. J Thromb Thrombolysis 45, 122–129 (2018). https://doi.org/10.1007/s11239-017-1575-0

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  • DOI: https://doi.org/10.1007/s11239-017-1575-0

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