Background and Objective
The CHADS2 and CHA2DS2–VASc score were used to evaluate the atrial fibrillation-related
risk of stroke, and HAS-BLED score was used to estimate the oral anticoagulation-bleeding
risk. We investigated the relationships between these 3 scores and the outcomes of
acute ischemic stroke (AIS) patients with rheumatic heart disease (RHD) at 3 months
after stroke.
Methods
We retrospectively included patients admitted within 1 month after stroke from October
2011 to February 2014 who was also diagnosed with RHD. The patients' demographics;
National Institutes of Health Stroke Scale score on admission; risk factors; prior
anticoagulation; and CHADS2, CHA2DS2–VASc, and HAS-BLED scores on admission were collected,
and symptomatic intracranial hemorrhage (sICH) during hospitalization was observed
as well. The patients were followed up at 3 months after stroke to assess the clinical
outcomes.
Results
Of 1425 patients with AIS, 172 patients were diagnosed with RHD. Eleven patients (6.4%)
were lost to follow-up at 3 months. One hundred sixty-one patients (48 males, mean
age 57.5 years) were finally analyzed in the study. The HAS-BLED score was associated
with the occurrence of sICH in both univariate (P = .001; odds ratio [OR] 2.223, 95% confidence interval [CI] 1.40-3.54) and multivariate
analysis (P = .031; OR 2.366, 95% CI 1.08-5.17). The CHADS2 and CHA2DS2–VASc scores were both
related to the sICH (CHADS2: P = .032; OR 1.522, 95% CI 1.04-2.23; CHA2DS2–VASc: P = .011; OR 1.498, 95% CI 1.10-2.04, respectively), and to the poor outcomes at 3
months (CHADS2: P = .013; OR .688, 95% CI .51-.92; CHA2DS2–VASc: P = .014; OR .754, 95% CI .60-.94, respectively) in the univariate analysis.
Conclusion
The HAS-BLED score was independently associated with the occurrence of sICH in AIS
patients with RHD.
Key Words
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Article info
Publication history
Published online: January 08, 2016
Accepted:
September 6,
2015
Received in revised form:
August 27,
2015
Received:
August 5,
2015
Footnotes
Conflict of interest: The authors declare that they have no financial disclosures or other conflicts of interest.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.09.003
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
