title: CHADS2 score is associated with 3-month clinical outcomes after intravenous rt-PA therapy in stroke patients with atrial fibrillation: SAMURAI rt-PA Registry.
abstract: OBJECTIVE
  The aim of this study was to examine whether CHADS(2) score is associated with clinical outcomes following recombinant tissue type plasminogen activator (rt-PA) therapy in stroke patients with atrial fibrillation (AF).
  
  
  METHODS
  We studied 218 consecutive stroke patients with AF [126 men, mean age 74.2 (SD 9.6) years] who received intravenous rt-PA therapy. CHADS(2) score was calculated as follows: 2 points for prior ischemic stroke and 1 point for each of the following: age≥75 years, hypertension, diabetes, and congestive heart failure.
  
  
  RESULTS
  Congestive heart failure was documented in 23 patients, hypertension in 138, age≥75 years in 116, diabetes in 35, and prior stroke in 35. The distribution of each CHADS(2) score was: score of 0, 16.1% of patients; 1, 30.3%; 2, 29.4%; and 3 to 5, 24.3%. The median initial NIHSS score for each CHADS(2) category was 12 (IQR 8-17), 16 (10-20), 14.5 (10-20.75), and 16 (11-21), respectively (p=0.168). Symptomatic ICH within the initial 36 h was found in 2.9%, 4.6%, 6.3%, and 0% of patients with each CHADS(2) category, respectively. Cardiovascular events within 3 months occurred in 0%, 0%, 7.8% and 5.7%, respectively. Percentage of patients with chronic independence at 3 months corresponding to modified Rankin Scale≤2 was 57.1%, 45.5%, 31.3%, and 28.3%, respectively. Adjusted CHADS(2) score was inversely associated with chronic independence (OR 0.72, 95% CI 0.55-0.93).
  
  
  CONCLUSIONS
  Lower CHADS(2) score was associated with chronic independence at 3 months after intravenous rt-PA therapy in stroke patients with AF.
authors.affiliation: Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Koga
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.forename: Kensaku
authors.initials: K
authors.lastname: Shibazaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shiokawa
authors.forename: Jyoji
authors.initials: J
authors.lastname: Nakagawara
authors.forename: Eisuke
authors.initials: E
authors.lastname: Furui
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamagami
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okada
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okuda
authors.forename: Masaki
authors.initials: M
authors.lastname: Naganuma
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nezu
authors.forename: Koichiro
authors.initials: K
authors.lastname: Maeda
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minematsu
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous / Q000379:methods; D008297:Male; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator