CHADS2, CHA2DS2-VASc, and R2CHADS2 scores are associated with 3-month functional outcome of stroke in patients with prior coronary artery disease.
BACKGROUND
Recent reports have shown that CHADS2 score can be applied to stroke risk in coronary artery disease (CAD) patients. This study evaluated the efficacy of CHADS2, CHA2DS2-VASc and R2CHADS2 scores as prognostic tools for stroke subsequent to CAD.


RESULTS
We enrolled 159 consecutive patients with acute ischemic stroke who were (1) living independently before stroke; and (2) diagnosed with CAD before stroke. Comparisons were made between patients with poor and good 3-month functional outcome (modified Rankin scale ≥3 and <3, respectively) with regard to clinical characteristics and pre-stroke CHADS2, CHA2DS2-VASc and R2CHADS2 scores. Multivariate analysis was used to assess the predictive value of each of the 3 scores for poor outcome. The patients with poor and good outcomes had significant differences in intracranial artery stenosis (31.4% vs. 14.9%; P=0.016), carotid artery stenosis (41.9% vs. 23.9%; P=0.019), atrial fibrillation (37.2% vs. 17.9%; P=0.008), NIHSS (11 vs. 5; P<0.001), CHADS2 (3 vs. 2; P=0.004), CHA2DS2-VASc (5 vs. 4; P=0.003), and R2CHADS2 (3 vs. 3; P=0.005). Multivariate analysis showed that CHADS2 >2 (OR, 1.65; 95% CI: 1.05-2.65; P=0.032), CHA2DS2-VASc >4 (OR, 1.60; 95% CI: 1.02-1.78; P=0.042), and R2CHADS2 >3 (OR, 1.57; 95% CI: 1.01-2.49; P=0.049) positively predicted poor outcome.


CONCLUSIONS
CHADS2, CHA2DS2-VASc and R2CHADS2 are useful in predicting functional status after stroke in CAD patients.
Department of Neurology, Tokyo Women's Medical University.
Takao
T
Hoshino
Kentaro
K
Ishizuka
Satoru
S
Shimizu
Shinichiro
S
Uchiyama
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology; D016893:Carotid Stenosis / Q000150:complications / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011237:Predictive Value of Tests; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology*