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- Publisher Website: 10.1111/pace.12445
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- PMID: 25039724
- WOS: WOS:000344549600004
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Article: Refinement of Ischemic Stroke Risk in Patients with Atrial Fibrillation and CHA2DS2‐VASc Score of 1
Title | Refinement of Ischemic Stroke Risk in Patients with Atrial Fibrillation and CHA2DS2‐VASc Score of 1 |
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Authors | |
Keywords | CHA2DS2‐VASc score atrial fibrillation and stroke |
Issue Date | 2014 |
Publisher | Wiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1 |
Citation | Pacing and Clinical Electrophysiology, 2014, v. 37 n. 11, p. 1442-1447 How to Cite? |
Abstract | BACKGROUND: Patients with atrial fibrillation (AF) with CHA2 DS2 -VASc score of 1 (where CHA2 DS2 -VASc is CHA2 DS2 -Vascular disease, Age 65-74 years, Sex category) are recommended to receive antithrombotic therapy. Nonetheless, it remains unclear whether individual components that constitute CHA2 DS2 -VASc score contribute equally to the ischemic stroke risk, particularly in patients with CHA2 DS2 -VASc score of 1. The objective was to describe and compare the risk of ischemic stroke of the six individual components constituting CHA2 DS2 -VASc among AF patients with CHA2 DS2 -VASc score of 1. METHODS AND RESULTS: We studied all patients with CHA2 DS2 -VASc score of 1 and no antithrombotic therapy from our cohort of 9,727 Chinese AF patients. A total of 548 patients were studied: 190 patients with CHA2 DS2 -VASc score of 0 and 358 patients with CHA2 DS2 -VASc score of 1. Of those with a baseline CHA2 DS2 -VASc score of 1, 51.1% patients aged 65-75; 29.3% patients were female; 12.0% had hypertension; 4.5% had heart failure; 2.5% had diabetes; and 0.6% had vascular disease. After 1,758 patient-years of follow-up, the annual incidence of stroke was 2.4% and 6.6% for patients with CHA2 DS2 -VASc score of 0 and 1, respectively. Compared with patients with CHA2 DS2 -VASc score of 0, patients with hypertension leading to CHA2 DS2 -VASc score of 1 were at the highest risk of stroke (Hazard ratio [HR]: 9.8, 95% confidence interval [CI]: 2.7-35.6), followed by patients aged 65-74 (HR: 3.9, 95% CI: 2.3-6.6) and female gender (HR: 2.3, 95% CI: 1.1-4.8). Heart failure, diabetes mellitus, and vascular disease were not associated with stroke. CONCLUSION: In AF patients with CHA2 DS2 -VASc score of 1, hypertension confers the highest risk for stroke among other risk factors comprising the score. A more aggressive thromboprophylaxis strategy may be justified among AF patients with CHA2 DS2 -VASc score of 1 due to hypertension. |
Persistent Identifier | http://hdl.handle.net/10722/275738 |
ISSN | 2023 Impact Factor: 1.7 2023 SCImago Journal Rankings: 0.579 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Huang, D | - |
dc.contributor.author | Luo, A | - |
dc.contributor.author | Yue, WS | - |
dc.contributor.author | Yin, LX | - |
dc.contributor.author | Tse, HF | - |
dc.contributor.author | Siu, DCW | - |
dc.date.accessioned | 2019-09-10T02:48:41Z | - |
dc.date.available | 2019-09-10T02:48:41Z | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | Pacing and Clinical Electrophysiology, 2014, v. 37 n. 11, p. 1442-1447 | - |
dc.identifier.issn | 0147-8389 | - |
dc.identifier.uri | http://hdl.handle.net/10722/275738 | - |
dc.description.abstract | BACKGROUND: Patients with atrial fibrillation (AF) with CHA2 DS2 -VASc score of 1 (where CHA2 DS2 -VASc is CHA2 DS2 -Vascular disease, Age 65-74 years, Sex category) are recommended to receive antithrombotic therapy. Nonetheless, it remains unclear whether individual components that constitute CHA2 DS2 -VASc score contribute equally to the ischemic stroke risk, particularly in patients with CHA2 DS2 -VASc score of 1. The objective was to describe and compare the risk of ischemic stroke of the six individual components constituting CHA2 DS2 -VASc among AF patients with CHA2 DS2 -VASc score of 1. METHODS AND RESULTS: We studied all patients with CHA2 DS2 -VASc score of 1 and no antithrombotic therapy from our cohort of 9,727 Chinese AF patients. A total of 548 patients were studied: 190 patients with CHA2 DS2 -VASc score of 0 and 358 patients with CHA2 DS2 -VASc score of 1. Of those with a baseline CHA2 DS2 -VASc score of 1, 51.1% patients aged 65-75; 29.3% patients were female; 12.0% had hypertension; 4.5% had heart failure; 2.5% had diabetes; and 0.6% had vascular disease. After 1,758 patient-years of follow-up, the annual incidence of stroke was 2.4% and 6.6% for patients with CHA2 DS2 -VASc score of 0 and 1, respectively. Compared with patients with CHA2 DS2 -VASc score of 0, patients with hypertension leading to CHA2 DS2 -VASc score of 1 were at the highest risk of stroke (Hazard ratio [HR]: 9.8, 95% confidence interval [CI]: 2.7-35.6), followed by patients aged 65-74 (HR: 3.9, 95% CI: 2.3-6.6) and female gender (HR: 2.3, 95% CI: 1.1-4.8). Heart failure, diabetes mellitus, and vascular disease were not associated with stroke. CONCLUSION: In AF patients with CHA2 DS2 -VASc score of 1, hypertension confers the highest risk for stroke among other risk factors comprising the score. A more aggressive thromboprophylaxis strategy may be justified among AF patients with CHA2 DS2 -VASc score of 1 due to hypertension. | - |
dc.language | eng | - |
dc.publisher | Wiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1 | - |
dc.relation.ispartof | Pacing and Clinical Electrophysiology | - |
dc.rights | Preprint This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Postprint This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. | - |
dc.subject | CHA2DS2‐VASc score | - |
dc.subject | atrial fibrillation and stroke | - |
dc.title | Refinement of Ischemic Stroke Risk in Patients with Atrial Fibrillation and CHA2DS2‐VASc Score of 1 | - |
dc.type | Article | - |
dc.identifier.email | Huang, D: huangduo@hku.hk | - |
dc.identifier.email | Tse, HF: hftse@hkucc.hku.hk | - |
dc.identifier.email | Siu, DCW: cwdsiu@hkucc.hku.hk | - |
dc.identifier.authority | Tse, HF=rp00428 | - |
dc.identifier.authority | Siu, DCW=rp00534 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1111/pace.12445 | - |
dc.identifier.pmid | 25039724 | - |
dc.identifier.scopus | eid_2-s2.0-84920439904 | - |
dc.identifier.hkuros | 304679 | - |
dc.identifier.volume | 37 | - |
dc.identifier.issue | 11 | - |
dc.identifier.spage | 1442 | - |
dc.identifier.epage | 1447 | - |
dc.identifier.isi | WOS:000344549600004 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0147-8389 | - |