Open AccessSimilar thrombolysis outcomes in acute stroke patients with and without atrial fibrillation if pre-stroke CHA2DS2-VASc score is low
Author(s) -
HungMing Wu,
ChihPing Chung,
Yung-Yang Lin
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000018680
Subject(s) - medicine , atrial fibrillation , cha2ds2–vasc score , thrombolysis , stroke (engine) , cardiology , acute stroke , ischemic stroke , tissue plasminogen activator , myocardial infarction , mechanical engineering , ischemia , engineering
The prognosis of acute ischemic stroke patients treated with intravenous (IV) recombinant tissue plasminogen activator (rtPA) is poorer in patients with atrial fibrillation (AF) than patients without AF, which might be related to the greater stroke severity in AF patients. Higher pre-stroke CHA 2 DS 2 -VASc scores are associated with greater stroke severity and poorer outcomes. AF Patients tend to have higher CHA 2 DS 2 -VASc scores than the non-AF patients. We thus hypothesized that pre-stroke CHA 2 DS 2 -VASc scores can be used to improve outcome stratification of IV thrombolysis therapy in acute stroke patients with and without AF. We retrospectively enrolled ischemic stroke patients who received IV-rtPA and categorized them into 2 groups: low-risk (CHA 2 DS 2 -VASc scores ≤ 2) and high-risk (CHA 2 DS 2 -VASc scores ≥ 3) groups. We compared the outcomes between AF and non-AF patients and the interactive effects of the levels of CHA 2 DS 2 -VASc scores on this outcome difference. In the low-risk group, there was no difference in outcomes between the AF and non-AF patients. In the high-risk group, the AF patients had worse outcomes at 3 and 6 months. Our results suggest that pre-stroke CHA 2 DS 2 -VASc scores are a useful outcome predictor of IV thrombolytic therapy in acute stroke patients with AF.