Evaluation Of CHA2DS2-VASc Score For Short-term Prognosis Of Ischemic Stroke Caused By NVAF

Objective:CHA2DS2-VASc score is a tool for predicting the risk of ischemic stroke in patients with nonvalvular atrial fibrillation(NVAF).However,whether this score can evaluate the prognosis of ischemic stroke patients with NVAF has not yet been confirmed.Therefore,this study is to explore the value of atrial fibrillation stroke risk score(CHA2DS2-VASc score)for short-term prognosis of the ischemic stroke patients with NVAF.Materials and Methods:We collected from clinical data of our hospital 109 ischemic strok patients with NVAF since December 2014 to September 2016.All patients were divided into four groups according to CHA2DS2-VASc: 0~1,2~3,4~5,?6 scores.The clinical data were compared between groups.According to the modified Rankin scale(mRS)score to evaluated at 3months after onset.Patients were divided into good prognosis group(0~2 scores)and poor prognosis group(3~6 scores).The clinical data were compared between groups.According to the degree of neurological deficit,patients were divided into mild(NIHSS:0 ~ 6 scores),moderate(NIHSS:7 ~15 scores),severe(NIHSS:16 ~ 42 scores),comparison of poor prognosis between different NIHSS groups and CHA2DS2-VASc scores.The value of CHA2DS2-VASc score in predicting the short-term prognosis of patients with NVAF ischemic stroke by ROC curve analysis.Results:Of 109 cases,55 cases were male(50.5%),54 cases were female(49.5%),the maximum age was 96 years old,the youngest 45 years old,the average age was(74.38±10.21)years old,hypertension in 68 cases(62.4%),diabetes in 33 cases(30.3%),congestive heart failure in 25 cases(22.9%),stroke or TIA history in 39 cases(35.8%),vascular diseases in 29 cases(26.6%),smoking history in 35 cases(32.1%),hyperlipidemia in 28 cases(25.7%).According to the mRS score,0~2 group had 46 cases(42.2%),3~6 group had 63 cases(57.8%).Single factor analysis showed that poor prognosis was associated with gender,smoking history,hypertension,congestive heart failure,stroke /TIA history,age,NIHSS score and CHA2DS2 VASc score.Multivariate analysis showed that NIHSS score at admission was an independent risk factor for poor prognosis in 3 months.There was significant difference between CHA2DS2-VASc score and poor prognosis when the patients admission NIHSS score ?15 scores.The CHA2DS2-VASc score was positively correlated with the mRS score at 3 months after onset(r=0.424,P<0.05).The area under the ROC curve was 0.796(95%CI:0.711 ~ 0.881,P<0.05),indicating that the CHA2DS2-VASc score was of high value in the short-term prognosis of patients.When CHA2DS2-VASc was 4.5,the value of short-term prognosis in patients with stroke was the highest,with a sensitivity of 0.603 and a specificity of 0.870.Conclusions:(1)CHA2DS2-VASc score may help to evaluate the early improvement and prognosis of ischemic stroke patients with NVAF,especially for the admission NIHSS score less than 15 points were.(2)NIHSS were independent risk factors for poor prognosis in patients with ischemic stroke caused by NVAF.(3)The CHA2DS2-VASc score was positively correlated with the mRS score at 3 months after onset(r=0.424,P<0.05).(4)The area under the ROC curve was 0.796(95%CI:0.711 ~ 0.881,P<0.05),indicating that the CHA2DS2-VASc score was of high value in the short-term prognosis of patients.When CHA2DS2-VASc was 4.5,the value of short-term prognosis in patients with stroke was the highest,with a sensitivity of 0.603 and a specificity of 0.870.We suggest that CHA2DS2-VASc score can be use to evaluate the early prognosis of ischemic stroke patients caused by NVAF.