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Article: Refinement of Ischemic Stroke Risk in Patients with Atrial Fibrillation and CHA2DS2‐VASc Score of 1

TitleRefinement of Ischemic Stroke Risk in Patients with Atrial Fibrillation and CHA2DS2‐VASc Score of 1
Authors
KeywordsCHA2DS2‐VASc score
atrial fibrillation and stroke
Issue Date2014
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
Citation
Pacing and Clinical Electrophysiology, 2014, v. 37 n. 11, p. 1442-1447 How to Cite?
AbstractBACKGROUND: Patients with atrial fibrillation (AF) with CHA2 DS2 -VASc score of 1 (where CHA2 DS2 -VASc is CHA2 DS2 -Vascular disease, Age 65-74 years, Sex category) are recommended to receive antithrombotic therapy. Nonetheless, it remains unclear whether individual components that constitute CHA2 DS2 -VASc score contribute equally to the ischemic stroke risk, particularly in patients with CHA2 DS2 -VASc score of 1. The objective was to describe and compare the risk of ischemic stroke of the six individual components constituting CHA2 DS2 -VASc among AF patients with CHA2 DS2 -VASc score of 1. METHODS AND RESULTS: We studied all patients with CHA2 DS2 -VASc score of 1 and no antithrombotic therapy from our cohort of 9,727 Chinese AF patients. A total of 548 patients were studied: 190 patients with CHA2 DS2 -VASc score of 0 and 358 patients with CHA2 DS2 -VASc score of 1. Of those with a baseline CHA2 DS2 -VASc score of 1, 51.1% patients aged 65-75; 29.3% patients were female; 12.0% had hypertension; 4.5% had heart failure; 2.5% had diabetes; and 0.6% had vascular disease. After 1,758 patient-years of follow-up, the annual incidence of stroke was 2.4% and 6.6% for patients with CHA2 DS2 -VASc score of 0 and 1, respectively. Compared with patients with CHA2 DS2 -VASc score of 0, patients with hypertension leading to CHA2 DS2 -VASc score of 1 were at the highest risk of stroke (Hazard ratio [HR]: 9.8, 95% confidence interval [CI]: 2.7-35.6), followed by patients aged 65-74 (HR: 3.9, 95% CI: 2.3-6.6) and female gender (HR: 2.3, 95% CI: 1.1-4.8). Heart failure, diabetes mellitus, and vascular disease were not associated with stroke. CONCLUSION: In AF patients with CHA2 DS2 -VASc score of 1, hypertension confers the highest risk for stroke among other risk factors comprising the score. A more aggressive thromboprophylaxis strategy may be justified among AF patients with CHA2 DS2 -VASc score of 1 due to hypertension.
Persistent Identifierhttp://hdl.handle.net/10722/275738
ISSN
2021 Impact Factor: 1.912
2020 SCImago Journal Rankings: 0.686
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorHuang, D-
dc.contributor.authorLuo, A-
dc.contributor.authorYue, WS-
dc.contributor.authorYin, LX-
dc.contributor.authorTse, HF-
dc.contributor.authorSiu, DCW-
dc.date.accessioned2019-09-10T02:48:41Z-
dc.date.available2019-09-10T02:48:41Z-
dc.date.issued2014-
dc.identifier.citationPacing and Clinical Electrophysiology, 2014, v. 37 n. 11, p. 1442-1447-
dc.identifier.issn0147-8389-
dc.identifier.urihttp://hdl.handle.net/10722/275738-
dc.description.abstractBACKGROUND: Patients with atrial fibrillation (AF) with CHA2 DS2 -VASc score of 1 (where CHA2 DS2 -VASc is CHA2 DS2 -Vascular disease, Age 65-74 years, Sex category) are recommended to receive antithrombotic therapy. Nonetheless, it remains unclear whether individual components that constitute CHA2 DS2 -VASc score contribute equally to the ischemic stroke risk, particularly in patients with CHA2 DS2 -VASc score of 1. The objective was to describe and compare the risk of ischemic stroke of the six individual components constituting CHA2 DS2 -VASc among AF patients with CHA2 DS2 -VASc score of 1. METHODS AND RESULTS: We studied all patients with CHA2 DS2 -VASc score of 1 and no antithrombotic therapy from our cohort of 9,727 Chinese AF patients. A total of 548 patients were studied: 190 patients with CHA2 DS2 -VASc score of 0 and 358 patients with CHA2 DS2 -VASc score of 1. Of those with a baseline CHA2 DS2 -VASc score of 1, 51.1% patients aged 65-75; 29.3% patients were female; 12.0% had hypertension; 4.5% had heart failure; 2.5% had diabetes; and 0.6% had vascular disease. After 1,758 patient-years of follow-up, the annual incidence of stroke was 2.4% and 6.6% for patients with CHA2 DS2 -VASc score of 0 and 1, respectively. Compared with patients with CHA2 DS2 -VASc score of 0, patients with hypertension leading to CHA2 DS2 -VASc score of 1 were at the highest risk of stroke (Hazard ratio [HR]: 9.8, 95% confidence interval [CI]: 2.7-35.6), followed by patients aged 65-74 (HR: 3.9, 95% CI: 2.3-6.6) and female gender (HR: 2.3, 95% CI: 1.1-4.8). Heart failure, diabetes mellitus, and vascular disease were not associated with stroke. CONCLUSION: In AF patients with CHA2 DS2 -VASc score of 1, hypertension confers the highest risk for stroke among other risk factors comprising the score. A more aggressive thromboprophylaxis strategy may be justified among AF patients with CHA2 DS2 -VASc score of 1 due to hypertension.-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1-
dc.relation.ispartofPacing and Clinical Electrophysiology-
dc.rightsPreprint This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Postprint This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectCHA2DS2‐VASc score-
dc.subjectatrial fibrillation and stroke-
dc.titleRefinement of Ischemic Stroke Risk in Patients with Atrial Fibrillation and CHA2DS2‐VASc Score of 1-
dc.typeArticle-
dc.identifier.emailHuang, D: huangduo@hku.hk-
dc.identifier.emailTse, HF: hftse@hkucc.hku.hk-
dc.identifier.emailSiu, DCW: cwdsiu@hkucc.hku.hk-
dc.identifier.authorityTse, HF=rp00428-
dc.identifier.authoritySiu, DCW=rp00534-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/pace.12445-
dc.identifier.pmid25039724-
dc.identifier.scopuseid_2-s2.0-84920439904-
dc.identifier.hkuros304679-
dc.identifier.volume37-
dc.identifier.issue11-
dc.identifier.spage1442-
dc.identifier.epage1447-
dc.identifier.isiWOS:000344549600004-
dc.publisher.placeUnited States-
dc.identifier.issnl0147-8389-

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