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CHA2DS2-VASc score and prognosis in ischemic strokes with atrial fibrillation

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An Erratum to this article was published on 13 December 2011

Abstract

The CHA2DS2-VASc score was developed to improve stroke risk stratification in atrial fibrillation (AF) patients. We sought to analyze the distribution and prognostic value of the CHA2DS2-VASc score in a cohort of ischemic stroke patients with AF. In total, 439 consecutive stroke patients with AF were studied. The CHA2DS2-VASc score was calculated according to clinical status before stroke onset. Poor outcome was defined as a modified Rankin score of 3 to 6 at 3 months. Association between CHA2DS2-VASc score and poor outcome was analyzed using logistic regression analysis. In 95.6% of patients, CHA2DS2-VASc was >1 and only 41.8% of those with previously diagnosed AF were using oral anticoagulation at the time of the stroke. Poor outcome was found in 53.1% of the patients. In univariate analysis age, female sex, current smoking, previous stroke, CHA2DS2-VASc score, and stroke severity were associated with outcome. In multivariate analysis, CHA2DS2-VASc score was independently associated with poor outcome [OR 1.36 (95% CI: 1.14–1.62), P = 0.001] as well as NIHSS [OR 1.22 (95% CI: 1.17–1.26), P < 0.001]. After removing stroke severity, therapeutic anticoagulation was also associated with stroke prognosis [OR 0.45 (95% CI: 0.23–0.86), P = 0.016]. Most patients with ischemic stroke and AF have a high CHA2DS2-VASc score. Independent of stroke severity, CHA2DS2-VASc score is associated with 3-month outcome. Despite all the available information and guidelines, our AF patients are clearly undertreated.

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Acknowledgments

This study was conducted with support from the Spanish Health Ministry, Instituto de Salud Carlos III, Red HERACLES (RD06/0009. FEDER).

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Authors and Affiliations

  1. Neurology Department, Neurovascular Research Group, IMIM-Hospital del Mar., Barcelona, Spain

    Eva Giralt-Steinhauer, Elisa Cuadrado-Godia, Ángel Ois, Jordi Jiménez-Conde, Ana Rodríguez-Campello & Jaume Roquer-González

  2. Neurology Department, Hospital del Mar., Passeig Maritim 25-29, 08003, Barcelona, Spain

    Eva Giralt-Steinhauer, Lluis Planellas, Sara Jimena-García & Miguel Ángel Rubio

Authors
  1. Eva Giralt-Steinhauer
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  2. Elisa Cuadrado-Godia
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  3. Ángel Ois
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  4. Jordi Jiménez-Conde
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  5. Ana Rodríguez-Campello
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  8. Miguel Ángel Rubio
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  9. Jaume Roquer-González
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Correspondence to Eva Giralt-Steinhauer.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00415-011-6351-z.

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Giralt-Steinhauer, E., Cuadrado-Godia, E., Ois, Á. et al. CHA2DS2-VASc score and prognosis in ischemic strokes with atrial fibrillation. J Neurol 259, 745–751 (2012). https://doi.org/10.1007/s00415-011-6259-7

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  • DOI: https://doi.org/10.1007/s00415-011-6259-7

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