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CHA2 DS2 -VASc scores for outcome prediction in acute ischaemic stroke

Chun-Hung Su1,2, Teng-Fu Tsao3,4, An-Chih Chen1,2

  • 1Division of Cardiology, Department of Internal Medicine, Chung-Shan Medical University Hospital Taichung, Taichung, Taiwan.

European Journal of Clinical Investigation
|December 31, 2017
PubMed

Insights

The CHA2DS2-VASc score, used for atrial fibrillation (AF) patients, can predict stroke severity and long-term outcomes in acute ischemic stroke patients. This score offers better clinical value than CHADS2 for predicting outcomes.

Area of Science:

  • Neurology
  • Cardiology
  • Stroke Medicine

Background:

  • CHADS2 and CHA2DS2-VASc scores are established risk stratification tools for stroke in atrial fibrillation (AF) patients.
  • Their utility in predicting acute ischemic stroke severity and long-term outcomes remains an area of investigation.

Purpose of the Study:

  • To evaluate the predictive value of prestroke CHADS2 and CHA2DS2-VASc scores for infarction severity and long-term outcomes in acute ischemic stroke patients.
  • To compare the predictive performance of these scores in patients with and without AF.

Main Methods:

  • Prospective study of 1494 acute ischemic stroke patients without hemorrhagic transformation.
  • Infarction volume and arterial stenosis assessed via MR imaging.
  • NIH Stroke Scale (NIHSS) scores recorded at admission and discharge.
  • Clinical outcomes (restroke, mortality) followed for a mean of 37.5 months.

Main Results:

  • Patients with AF (13.1%) had higher CHADS2 and CHA2DS2-VASc scores.
  • Higher scores correlated with increased infarction volume, arterial stenosis, NIHSS scores, and poorer outcomes.
  • After adjustment, only CHA2DS2-VASc scores predicted restroke and composite endpoints.

Conclusions:

  • Prestroke CHA2DS2-VASc scores demonstrate significant clinical value in predicting infarction severity and long-term outcomes.
  • The CHA2DS2-VASc score appears superior to the CHADS2 score for this predictive purpose in acute ischemic stroke patients, irrespective of AF status.
Abstract

Keywords:
CHA2DS2-VASc scoreacute ischaemic strokeatrial fibrillationinfarction severity

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