NDLI: The association between asymptomatic coronary artery disease and CHADS2 and CHA2 DS2 -VASc scores in patients with stroke.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Cha, M-J Lee, H. S. Kim, Y. D. Nam, H. S. Heo, J. H.
Description	Author Affiliation: Cha MJ ( Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.)
Abstract	BACKGROUND AND PURPOSE: CHADS2 and CHA2 DS2 -VASc scores are measurement tools that stratify thromboembolic risk in patients with non-valvular atrial fibrillation, and are predictive of cerebral atherosclerosis, fatal stroke and ischaemic heart disease. Patients with higher CHADS2 and CHA2 DS2 -VASc scores are more likely to have had an akinetic/hypokinetic left ventricular segment or a recent myocardial infarction, all of which are associated with coronary artery disease (CAD). Most of the CHADS2 score components are also risk factors for atherosclerosis. Thus, CHADS2 and CHA2 DS2 -VASc scores may be predictive of CAD. METHODS: In all, 1733 consecutive patients with acute ischaemic stroke who underwent multi-slice computed tomography coronary angiography were enrolled. The association of CHADS2 and CHA2 DS2 -VASc scores with the presence and severity of CAD was investigated. RESULTS: Of the 1733 patients, 1220 patients (70.4%) had any degree of CAD and 576 (33.3%) had significant CAD (≥ 50% stenosis in at least one coronary artery). As the CHADS2 and CHA2 DS2 -VASc scores increased, the presence of CAD also increased (P < 0.001). The severity of CAD was correlated with CHADS2 score (Spearman coefficient 0.229, P < 0.001) and CHA2 DS2 -VASc score (Spearman coefficient 0.261, P < 0.001). In multivariate analysis, after adjusting for confounding factors, CHADS2 and CHA2 DS2 -VASc scores ≥2 were independently associated with CAD. The CHA2 DS2 -VASc score was a better predictor of the presence of CAD than the CHADS2 score on area under the curve analysis. CONCLUSION: CHADS2 and CHA2 DS2 -VASc scores were predictive of the presence and severity of CAD in patients with stroke. When a patient has high CHADS2 or CHA2 DS2 -VASc scores, physicians should consider coronary artery evaluation.
File Format	HTM / HTML
ISSN	13515101
Issue Number	9
Volume Number	20
e-ISSN	14681331
Journal	European Journal of Neurology
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2013-09-01
Publisher Place	Great Britain (UK)
Access Restriction	Subscribed
Subject Keyword	Research Support, Non-u.s. Gov't Stroke Risk Assessment Complications Humans Middle Aged Risk Factors Male Predictive Value Of Tests Coronary Artery Disease Journal Article Coronary Angiography Discipline Neurology Female Aged Methods
Content Type	Text
Resource Type	Article
Subject	Neurology Neurology (clinical)

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