title: Predicting the outcomes of acute ischaemic stroke in atrial fibrillation: the role of baseline CHADS2, CHA2DS2-VASC and HAS-BLED score values.
abstract: OBJECTIVE
  Atrial fibrillation (AF)-related risk of stroke is commonly assessed using the CHADS2 or CHA2DS2-VASc score, whilst the oral anticoagulation-related bleeding risk can be estimated by the HAS-BLED score. We investigated the association of these scores with outcomes of AF-associated strokes, defined as symptomatic intracranial haemorrhage (sICH), favourable outcome (modified Rankin Scale [mRS] 0-2) or death.
  
  
  METHODS
  Analyses of prospective data on stroke patients with non-valvular AF treated in the Stroke Unit from January 2009 to June 2012 were performed.
  
  
  RESULTS
  Of 787 patients with an acute ischaemic stroke, 131 had AF (16.6%, median age 70, range 62-76 years). Of those, 6 patients (4.6%) had sICH, 49 (37.4%) died and 55 (42.0%) had a favourable 90-day outcome. HAS-BLED score of > or = 3 was associated with sICH both in the univariate analysis (OR 15.13; 95% CI 2.11-108.25, P = 0.007) and in the multivariable model (OR 19.96; 95% CI 2.23-178.81, P = 0.007), which also included the baseline neurological deficit score (NIHSS), intravenous thrombolysis or the use of antiplatelet/anticoagulant therapy. The CHADS2 and CHA2DS2-VASc scores were associated with 90-day mortality in the univariate analyses (OR 1.47; 95% CI 1.11-1.95 and OR 1.36; 95% CI 1.08-1.69, respectively, both P = 0.008). The CHA2DS2-VASc score was inversely related to the favourable outcome in the univariate analysis (OR 0.80; 95% CI 0.65-0.99, P = 0.042).
  
  
  CONCLUSIONS
  HAS-BLED was found to have an independent predictive value on the occurrence of sICH regardless of the treatment (thrombolysis or conservative therapy). A trend toward statistical relation to the influence of the CHA2DS2-VASc values on the favourable outcome was registered.
authors.affiliation: Neurology Clinic, Clinical Centre of Serbia. visnja.padjen@hotmail.com
authors.forename: Visnja
authors.initials: V
authors.lastname: Padjen
authors.affiliation: Neurology Clinic, Clinical Centre of Serbia.
authors.forename: Dejana R
authors.initials: DR
authors.lastname: Jovanovic
authors.affiliation: Dept. of Neurology, Lille University Hospital, 4EA 1046, University Lille Nord de France, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Leys
authors.affiliation: Neurology Clinic, Clinical Centre of Serbia.
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Beslac-Bumbasirevic
mesh_terms: D000208:Acute Disease; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D002545:Brain Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends