Rate of Antithrombotic Drug use and Clinical Outcomes According to CHADS2 Scores in Patients With an Initial Cardioembolic Stroke who had Nonvalvular Atrial Fibrillation
| Autor: | Hiroshi Ogawa, Ichiro Deguchi, Norio Tanahashi, Yasuko Ohe, Manabu Nemoto |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Drug medicine.medical_specialty Time Factors Heart Diseases media_common.quotation_subject Logistic regression Severity of Illness Index Disability Evaluation Drug Utilization Review Patient Admission Fibrinolytic Agents Risk Factors Modified Rankin Scale Internal medicine Atrial Fibrillation Antithrombotic medicine Humans In patient Practice Patterns Physicians' Aged Retrospective Studies media_common Aged 80 and over Cardioembolic stroke Chi-Square Distribution business.industry Patient Selection Rehabilitation Warfarin Atrial fibrillation medicine.disease Surgery Stroke Logistic Models Treatment Outcome Intracranial Embolism Female Neurology (clinical) Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 22:846-850 |
| ISSN: | 1052-3057 |
| Popis: | Background This study investigated the relationship between CHADS2 scores and the rate of antithrombotic drug use and clinical outcomes in patients with an initial cardioembolic stroke who had nonvalvular atrial fibrillation (NVAF). Methods In 234 patients (135 men and 99 women; mean age [±SD] 76 ± 11 years) with initial cardiogenic cerebral embolism with NVAF who were admitted to our hospital between April 2007 and March 2011, the CHADS2 score, use of warfarin, and clinical outcomes were retrospectively investigated. Results CHADS2 scores were as follows: 0 points, n = 21 (9%); 1 point, n = 72 (31%); 2 points, n = 92 (39%); 3 points, n = 47 (20%); and 4 points, n = 2 (1%). The overall warfarin use rate was low (14.1%; n = 33), and it was significantly (P = .023) lower for paroxysmal atrial fibrillation (8%) than for chronic atrial fibrillation (18.5%). The clinical outcomes evaluated by the modified Rankin Scale (mRS) score after 3 months were: CHADS2 score 0 points, mRS 0 to 2 (81%) and 3 to 6 (19%); 1 point, mRS 0 to 2 (46%) and 3 to 6 (54%); 2 points, mRS 0 to 2 (46%) and 3 to 6 (54%); and ≥3 points, mRS 0 to 2 (29%) and 3 to 6 (71%). The clinical outcome worsened as the CHADS2 score increased (P = .002). Logistic regression analysis revealed that being ≥75 years of age and having a high National Institutes of Health Stroke Scale (NIHSS) score on admission were related to a poor outcome (P < .001). Conclusions The overall warfarin use rate was low in initial cardioembolic stroke patients with NVAF. Clinical outcomes deteriorated with increases in the CHADS2 score, age ≥75 years, and NIHSS score on admission were related to a poor clinical outcome. |
| Databáze: | OpenAIRE |
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