The CHADS2 Score to Predict Stroke Risk in the Absence of Atrial Fibrillation in Hypertensive Patients Aged 65 Years or Older

Morillas, Pedro; Pallarés, Vicente; Fácila, Lorenzo; Llisterri, J.L.; Sebastián, María Eugenia; Gómez, Manuel; Castilla, Elena; Camarasa, Raquel; Sandín, Miriam; García-Honrubia, Antonio

doi:10.1016/j.rec.2014.06.027

Cited by 14 publications

(14 citation statements)

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“…Thus, the absence of AF in a patient does not make him/her thromboembolism risk-free. 2,3 As the risk factors for ischemic thromboembolism, such as age, hypertension, diabetes, heart failure, and vascular disease, are dynamic rather than stable in nature, the risk score of each patient may change over time. When we use longer monitorization devices such as an implantable loop recorder, the detection rates of AF recurrence increase significantly (∼40-60%).…”

Section: Impact Of Successful Catheter Ablation For Af On the "Dynamimentioning

confidence: 99%

“…The risk for thromboembolism was similar in patients with one risk factor and no prior stroke or AF versus AF alone. Thus, the absence of AF in a patient does not make him/her thromboembolism risk‐free . As the risk factors for ischemic thromboembolism, such as age, hypertension, diabetes, heart failure, and vascular disease, are dynamic rather than stable in nature, the risk score of each patient may change over time.…”

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Impact of successful catheter ablation for AF on the “dynamic nature” of stroke risk to give up anticoagulation: Fact or fiction?

Canpolat

2019

Pacing Clinical Electrophis

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Section: Impact Of Successful Catheter Ablation For Af On the "Dynamimentioning

confidence: 99%

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Impact of successful catheter ablation for AF on the “dynamic nature” of stroke risk to give up anticoagulation: Fact or fiction?

Canpolat

2019

Pacing Clinical Electrophis

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“…The application of CHA 2 DS 2 ‐VASc score in patients without AF is relatively new and only a few non‐AF studies have explored this simple method of risk assessment 3, 4, 5…”

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confidence: 99%

“…The application of CHA 2 DS 2 -VASc score in patients without AF is relatively new and only a few non-AF studies have explored this simple method of risk assessment. [3][4][5] Goto et al 6 demonstrated the potential of CHADS 2 score in predicting not only stroke but also cardiovascular death in stable outpatients at risk of atherothrombosis. Moreover, the CHADS 2 score has been reported to have a prognostic role in acute coronary syndrome patients without AF.…”

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confidence: 99%

Risk Stratification Using the CHA ₂ DS ₂ ‐VASc Score in Takotsubo Syndrome: Data From the Takotsubo Italian Network

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BackgroundThe CHA2DS2‐VASc score predicts stroke in patients with atrial fibrillation and has been reported to have a prognostic role even in acute coronary syndrome patients. The Takotsubo syndrome is a condition that mimics acute coronary syndrome and may present several complications including stroke. We sought to assess the ability of CHA2DS2‐VASc score to predict adverse events in Takotsubo syndrome patients.Methods and ResultsOverall, 371 Takotsubo syndrome patients were enrolled in a prospective registry. Patients were divided into 3 groups according to the CHA2DS2‐VASc score: Group A (≤1), B (2–3), and C (≥4). The median CHA2DS2‐VASc score was 3 (interquartile range: 2–4). Overall, 9%, 42%, and 49% were included in Group A, B, and C, respectively. Follow‐up length was 26±20 months. The mortality rate was 6%, 7%, and 17% in Group A, B, and C, respectively (P=0.011). The stroke rate was 3% and not different among the 3 groups. Estimated major adverse cardiac and cerebrovascular events (the composite of death, myocardial infarction, and stroke) rates in the 3 groups were 6%, 9%, and 17% in Group A, B, and C, respectively (P=0.033). The CHA2DS2‐VASc score resulted as a predictor of major adverse cardiac and cerebrovascular events (odds ratio 2.1, 95% confidence interval, 1.2–3.6; P=0.01) and all‐cause mortality (odds ratio 1.5, 95% confidence interval, 1.2–1.9; P=0.001).ConclusionsIn Takotsubo syndrome, the CHA2DS2‐VASc score allows prediction of cardiovascular events and mortality at long‐term follow‐up.

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“…In addition, it may be of help for risk stratification in patients admitted for an acute myocardial infarction. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] This score has also been used to predict adverse events after coronary revascularization. Importantly, in patients with known coronary artery disease, higher CHADS scores have been linked to a poor prognosis and a higher rate of adverse clinical outcomes following PCI and bypass grafting surgery.…”

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CHA₂DS₂-VAS_C Clinical Score to Predict In-Stent Restenosis

2017

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Keywords in-stent restenosis, bare metal stents, drug eluting stents, risk score, CHA 2 DS 2 -VASc Stent implantation is the default strategy for percutaneous coronary intervention (PCI).1 Acute recoil and residual dissections as well as late recoil, a major determinant of restenosis after balloon angioplasty, are prevented by stents.2,3 However, stenting induces vessel wall injury that promotes neointimal hyperplasia which is greater after bare metal stent (BMS) implantation than following balloon angioplasty.2,3 Nevertheless, the larger initial lumen gain and the elimination of acute and late recoil by BMS translates into a larger coronary lumen at follow-up and significantly reduced restenosis rates. 2,3However, in-stent restenosis (ISR) remains a major limitation of PCI. 4The main underlying mechanism of ISR is neointimal proliferation, though neoatherosclerosis has also been implicated. 4 Drug-eluting stents (DES) were introduced with the aim of inhibiting neointimal hyperplasia, but ISR may still occur, especially when DES are implanted in adverse clinical and anatomic scenarios. 4 In addition, DES require prolonged dual antiplatelet therapy (DAPT).5 Some patients are unable to adhere to prolonged DAPT regimens or have a high risk of bleeding.5 Dual antiplatelet therapy is also a cause of concern in patients with atrial fibrillation (AF) or any other condition requiring chronic oral anticoagulation.5 Finally, economic issues may limit the universal use of DES. These factors explain why a number of patients still receive a BMS.Several clinical, angiographic, and procedure-related factors have been implicated in the pathogenesis of ISR.6-9 Among the clinical factors, diabetes emerges as the most important risk factor for aggressive neointimal proliferation.8 Vessel size and lesion length represent key determinants for recurrent stenosis after stent implantation.6-9 Suboptimal stent implantation (mainly underexpansion) secondary to either a poor deployment technique or complex anatomy has been related to late stent failure. 4 However, predicting ISR risk in an individual patient remains a challenge. [6][7][8][9] In a previous issue of Angiology, Yilmaz et al 10 assessed the potential of the CHA 2 DS 2 -VASc score to predict the occurrence of ISR after BMS implantation in patients free from AF. The CHA 2 DS 2 -VASc score assigns 1 point for congestive heart failure, hypertension, age 65 to 74 years, diabetes mellitus, vascular disease and female sex, and 2 points for age 75 years or older and previous stroke.11 In this study, patients (n ¼ 1350) undergoing successful BMS implantation were retrospectively analyzed; 700 of these patients were included in the final analysis (age 61.4 + 9 years, 63% men). The mean time from initial stent implantation to late coronary angiography was 14.2 + 3.5 months. At late follow-up, 265 (38%) patients developed ISR. Those presenting with ISR more frequently had diabetes, hyperlipidemia, history of cerebrovascular events, or heart failure and were more frequently smokers. Left ...

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The CHADS2 Score to Predict Stroke Risk in the Absence of Atrial Fibrillation in Hypertensive Patients Aged 65 Years or Older

Cited by 14 publications

References 29 publications

Impact of successful catheter ablation for AF on the “dynamic nature” of stroke risk to give up anticoagulation: Fact or fiction?

Impact of successful catheter ablation for AF on the “dynamic nature” of stroke risk to give up anticoagulation: Fact or fiction?

Risk Stratification Using the CHA ₂ DS ₂ ‐VASc Score in Takotsubo Syndrome: Data From the Takotsubo Italian Network

CHA₂DS₂-VAS_C Clinical Score to Predict In-Stent Restenosis

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The CHADS2 Score to Predict Stroke Risk in the Absence of Atrial Fibrillation in Hypertensive Patients Aged 65 Years or Older

Cited by 14 publications

References 29 publications

Impact of successful catheter ablation for AF on the “dynamic nature” of stroke risk to give up anticoagulation: Fact or fiction?

Impact of successful catheter ablation for AF on the “dynamic nature” of stroke risk to give up anticoagulation: Fact or fiction?

Risk Stratification Using the CHA 2 DS 2 ‐VASc Score in Takotsubo Syndrome: Data From the Takotsubo Italian Network

CHA2DS2-VASC Clinical Score to Predict In-Stent Restenosis

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Risk Stratification Using the CHA ₂ DS ₂ ‐VASc Score in Takotsubo Syndrome: Data From the Takotsubo Italian Network

CHA₂DS₂-VAS_C Clinical Score to Predict In-Stent Restenosis