The Study Of Predictive Effects Of CHADS₂Scores On Risk Of Ischemic Stroke In Acute Coronary Syndrome Patients Without Atrial Fibrillation

Objective:To evaluate the predictive effects of CHADS2score on risk of ischemic stroke for the acute coronary syndrome patients without atrial fibrillationMethods:We screened the datas of in hospital patients diagnosed as acute coronary syndrome within one year from Mar2011to Mar2012in cardiology department of Xiangdong Hospital in Hunan province, and310cases are without atrial fibrillation. They are divided into3groups: low-risk group (0-1score), intermediate-risk group (2-3scores) and high-risk group (4-6scores) according to CHADS2score. Meanwhile, we screened the datas of272cases of stable angina pectoris without atrial fibrillation as control group in the same period, and they were also divided into3groups:low-risk group (0-1score), intermediate-risk group (2-3scores) and high-risk group (4-6scores) according to CHADS2score. We analysed the correlation between the CHADS2score and the incidence of secondary ischemic stroke in acute coronary syndrome patients without atrial fibrillation after24months follow up, and evaluated the predictive value of CHADS2score.Results:1. The incidence of ischemic stroke were5.81%and2.20%respectively in acute coronary syndrome patients without atrial fibrillation and stable angina pectoris patients without atrial fibrillation after24months follow up, the difference was statistically significant (P <0.05). The incidence of ischemic stroke in acute coronary syndrome patients without atrial fibrillation were2.85%、3.57%、4.76%、7.14%、7.40%、8.00%、15.00%respectively in patients with0,1,2,3,4,5,6CHADS2score. The incidence of ischemic stroke in stable angina pectoris patients without atrial fibrillation were0%、0%、2.17%、3.70%、4.55%、4.76%、5.26%respectively in patients with0,1,2,3,4,5,6CHADS2score. The difference was statistically significant between two groups in respective to the incidence of ischemic stroke in patients with CHADS26scores (15.00%vs5.26%, P<0.05). The differences were no statistically significant between two groups in respective to the incidence of ischemic stroke in patients with CHADS20,1,2,3,4,5score (2.85%vs0%、3.57%vs0%、4.76%vs2.17%、7.14%vs3.70%、7.40%vs4.55%、8.00%vs4.76%, all P>0.05)2. The odds ratio of heart failure, hypertension, diabetes, stroke/transient ischemic attack were1.80,1.92,1.98,2.84respectively related to ischemic stroke in acute coronary syndrome patients without atrial fibrillation after24months follow up, and the differences all were statistically significant (P<0.05). The odds ratio of age>75,65<age<74, age<65were2.74,1.75,1.58respectively and the differences all were statistically significant (P<0.05). The odds ratio of gender was1.34, and the difference was no statistically significant (P>0.05).3. For acute coronary syndrome patients without atrial fibrillation after24months follow up, After adjustment for age, smoking, use of drugs, body mass index, those with CHADS2scores of2-3had1.8times the rate of ischemic stroke, compared with the reference group of subjects with CHADS2score of0-1, the difference was statistically significant (P<0.05). Those with CHADS2score of4-6had3.2times the rate, compared with the reference group of subjects with CHADS2score of0-1and the difference was statistically significant (P<0.05).Conclusions:1. The higher the value of the CHADS2score, the higher the incidence of ischemic stroke in acute coronary syndrome patients without atrial fibrillation.2. Heart failure, hypertension, diabetes, stroke/transient ischemic attack, age were risk factors of ischemic stroke for acute coronary syndrome patients, in contrast, gender was not risk factor.3. The value of CHADS2score can predict the risk of ischemic stroke in acute coronary syndrome patients.