@article{3108642,
    title = "Prestroke CHA2DS2-VASc Score and Severity of Acute Stroke in Patients with Atrial Fibrillation: Findings from RAF Study",
    author = "Acciarresi, M. and Paciaroni, M. and Agnelli, G. and Falocci, N. and Caso, V. and Becattini, C. and Marcheselli, S. and Rueckert, C. and Pezzini, A. and Morotti, A. and Costa, P. and Padovani, A. and Csiba, L. and Szabó, L. and Sohn, S.-I. and Tassinari, T. and Abdul-Rahim, A.H. and Michel, P. and Cordier, M. and Vanacker, P. and Remillard, S. and Alberti, A. and Venti, M. and D'Amore, C. and Scoditti, U. and Denti, L. and Orlandi, G. and Chiti, A. and Gialdini, G. and Bovi, P. and Carletti, M. and Rigatelli, A. and Putaala, J. and Tatlisumak, T. and Masotti, L. and Lorenzini, G. and Tassi, R. and Guideri, F. and Martini, G. and Tsivgoulis, G. and Vadikolias, K. and Liantinioti, C. and Corea, F. and Del Sette, M. and Ageno, W. and De Lodovici, M.L. and Bono, G. and Baldi, A. and D'Anna, S. and Sacco, S. and Carolei, A. and Tiseo, C. and Imberti, D. and Zabzuni, D. and Doronin, B. and Volodina, V. and Consoli, D. and Galati, F. and Pieroni, A. and Toni, D. and Monaco, S. and Baronello, M.M. and Barlinn, K. and Pallesen, L.-P. and Kepplinger, J. and Bodechtel, U. and Gerber, J. and Deleu, D. and Melikyan, G. and Ibrahim, F. and Akhtar, N. and Mosconi, M.G. and Lees, K.R.",
    journal = "Journal of Stroke and Cerebrovascular Diseases",
    year = "2017",
    volume = "26",
    number = "6",
    pages = "1363-1368",
    publisher = "W.B. Saunders",
    issn = "1052-3057",
    doi = "10.1016/j.jstrokecerebrovasdis.2017.02.011",
    keywords = "adverse outcome;  aged;  alcohol abuse;  Article;  atrial fibrillation;  brain ischemia;  cardiac patient;  cardiovascular mortality;  cardiovascular risk;  cerebrovascular accident;  CHA2DS2 VASc score;  CHADS2 score;  computer assisted tomography;  disability;  disease association;  disease severity;  female;  fibrinolytic therapy;  hospital admission;  human;  major clinical study;  male;  multicenter study;  National Institutes of Health Stroke Scale;  priority journal;  prospective study;  Rankin scale;  stroke unit;  area under the curve;  Asia;  atrial fibrillation;  cerebrovascular accident;  chi square distribution;  clinical trial;  complication;  decision support system;  Europe;  mortality;  multivariate analysis;  nuclear magnetic resonance imaging;  odds ratio;  predictive value;  prognosis;  receiver operating characteristic;  risk assessment;  risk factor;  severity of illness index;  statistical model;  time factor;  very elderly;  x-ray computed tomography, Aged;  Aged, 80 and over;  Area Under Curve;  Asia;  Atrial Fibrillation;  Chi-Square Distribution;  Decision Support Techniques;  Disability Evaluation;  Europe;  Female;  Humans;  Linear Models;  Logistic Models;  Magnetic Resonance Imaging;  Male;  Multivariate Analysis;  Odds Ratio;  Predictive Value of Tests;  Prognosis;  Prospective Studies;  Risk Assessment;  Risk Factors;  ROC Curve;  Severity of Illness Index;  Stroke;  Time Factors;  Tomography, X-Ray Computed",
    abstract = "Background and Purpose The aim of this study was to investigate for a possible association between both prestroke CHA2DS2-VASc score and the severity of stroke at presentation, as well as disability and mortality at 90 days, in patients with acute stroke and atrial fibrillation (AF). Methods This prospective study enrolled consecutive patients with acute ischemic stroke, AF, and assessment of prestroke CHA2DS2-VASc score. Severity of stroke was assessed on admission using the National Institutes of Health Stroke Scale (NIHSS) score (severe stroke: NIHSS ≥10). Disability and mortality at 90 days were assessed by the modified Rankin Scale (mRS <3 or ≥3). Multiple logistic regression was used to correlate prestroke CHA2DS2-VASc and severity of stroke, as well as disability and mortality at 90 days. Results Of the 1020 patients included in the analysis, 606 patients had an admission NIHSS score lower and 414 patients higher than 10. At 90 days, 510 patients had mRS ≥3. A linear correlation was found between the prestroke CHA2DS2-VASc score and severity of stroke (P = .001). On multivariate analysis, CHA2DS2-VASc score correlated with severity of stroke (P = .041) and adverse functional outcome (mRS ≥3) (P = .001). A logistic regression with the receiver operating characteristic graph procedure (C-statistics) evidenced an area under the curve of .60 (P = .0001) for severe stroke. Furthermore, a correlation was found between prestroke CHA2DS2-VASc score and lesion size. Conclusions In patients with AF, in addition to the risk of stroke, a high CHA2DS2-VASc score was independently associated with both stroke severity at onset and disability and mortality at 90 days. © 2017 National Stroke Association"
}