Predicting the Outcomes of Acute Ischemic Stroke with Rheumatic Heart Disease: The Values of CHADS2, CHA2DS2–VASc, and HAS-BLED Scores

Background and Objective The CHADS2 and CHA2DS2–VASc score were used to evaluate the atrial fibrillation-related risk of stroke, and HAS-BLED score was used to estimate the oral anticoagulation-bleeding risk. We investigated the relationships between these 3 scores and the outcomes of acute ischemic...

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Published inJournal of stroke and cerebrovascular diseases Vol. 25; no. 3; pp. 722 - 726
Main Authors Liu, Junfeng, MD, Wang, Deren, PhD, Tan, Ge, MD, Yuan, Ruozhen, MD, Xu, Mangmang, MD, Xiong, Yao, MD, Liu, Ming, MD, PhD
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.03.2016
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Summary:Background and Objective The CHADS2 and CHA2DS2–VASc score were used to evaluate the atrial fibrillation-related risk of stroke, and HAS-BLED score was used to estimate the oral anticoagulation-bleeding risk. We investigated the relationships between these 3 scores and the outcomes of acute ischemic stroke (AIS) patients with rheumatic heart disease (RHD) at 3 months after stroke. Methods We retrospectively included patients admitted within 1 month after stroke from October 2011 to February 2014 who was also diagnosed with RHD. The patients' demographics; National Institutes of Health Stroke Scale score on admission; risk factors; prior anticoagulation; and CHADS2, CHA2DS2–VASc, and HAS-BLED scores on admission were collected, and symptomatic intracranial hemorrhage (sICH) during hospitalization was observed as well. The patients were followed up at 3 months after stroke to assess the clinical outcomes. Results Of 1425 patients with AIS, 172 patients were diagnosed with RHD. Eleven patients (6.4%) were lost to follow-up at 3 months. One hundred sixty-one patients (48 males, mean age 57.5 years) were finally analyzed in the study. The HAS-BLED score was associated with the occurrence of sICH in both univariate ( P  = .001; odds ratio [OR] 2.223, 95% confidence interval [CI] 1.40-3.54) and multivariate analysis ( P  = .031; OR 2.366, 95% CI 1.08-5.17). The CHADS2 and CHA2DS2–VASc scores were both related to the sICH (CHADS2: P  = .032; OR 1.522, 95% CI 1.04-2.23; CHA2DS2–VASc: P  = .011; OR 1.498, 95% CI 1.10-2.04, respectively), and to the poor outcomes at 3 months (CHADS2: P  = .013; OR .688, 95% CI .51-.92; CHA2DS2–VASc: P  = .014; OR .754, 95% CI .60-.94, respectively) in the univariate analysis. Conclusion The HAS-BLED score was independently associated with the occurrence of sICH in AIS patients with RHD.
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ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2015.09.003