Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS2, CHA2DS2-VASc score, underuse of oral anticoagulation, and implications for preventive measures
Background and purpose Atrial fibrillation (AF) is amongst the most important etiologies of ischaemic stroke. In a population-based stroke registry, we tested the hypothesis of low adherence to current guidelines as a main cause of high rates of AF-associated stroke. Methods Within the Ludwigshafen...
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| Hauptverfasser: | , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2013
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| In: |
European journal of neurology
Year: 2013, Jahrgang: 20, Heft: 1, Pages: 117-123 |
| ISSN: | 1468-1331 |
| DOI: | 10.1111/j.1468-1331.2012.03804.x |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1111/j.1468-1331.2012.03804.x Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1468-1331.2012.03804.x 
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| Verfasserangaben: | F. Palm, T. Kleemann, M. Dos Santos, C. Urbanek, F. Buggle, A. Safer, M.G. Hennerici, H. Becher, R. Zahn and A.J. Grau |
MARC
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| 245 | 1 | 0 | |a Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS2, CHA2DS2-VASc score, underuse of oral anticoagulation, and implications for preventive measures |c F. Palm, T. Kleemann, M. Dos Santos, C. Urbanek, F. Buggle, A. Safer, M.G. Hennerici, H. Becher, R. Zahn and A.J. Grau |
| 246 | 3 | 3 | |a Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS 2, CHA 2 DS 2-VASc score, underuse of oral anticoagulation, and implications for preventive measures |
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| 500 | |a Im Titel ist die Ziffer "2" jeweils tiefgestellt | ||
| 500 | |a Gesehen am 16.12.2021 | ||
| 520 | |a Background and purpose Atrial fibrillation (AF) is amongst the most important etiologies of ischaemic stroke. In a population-based stroke registry, we tested the hypothesis of low adherence to current guidelines as a main cause of high rates of AF-associated stroke. Methods Within the Ludwigshafen Stroke Study (LuSSt), a prospective ongoing population-based stroke register, we analyzed all patients with a first-ever ischaemic stroke (FEIS) owing to AF in 2006 and 2007. We determined whether AF was diagnosed before stroke and assessed pre-stroke CHADS2 and CHA2DS2-VASc scores. Results In total, 187 of 626 patients with FEIS suffered from cardioembolic stroke owing to AF, which was newly diagnosed in 57 (31%) patients. Retrospective pre-stroke risk stratification according to CHADS2 score indicated low/intermediate risk in 34 patients (18%) and high risk (CHADS2 ≥ 2) in 153 patients (82%). Application of CHA2DS2-VASc score reduced number of patients at low/intermediate risk (CHA2DS2-VASc score 0-1) to five patients (2.7%). In patients with a CHADS2 score ≥ 2 and known AF (n = 106) before stroke, 38 (36%) were on treatment with vitamin K antagonists on admission whilst only in 16 patients (15%) treatment was in therapeutic range. Conclusions Our study strongly supports the hypothesis that underuse of oral anticoagulants in high-risk patients importantly contributes to AF-associated stroke. CHA2DS2-VASc score appears to be a more valuable risk stratification tool than CHADS2 score. Preventive measures should focus on optimizing pre-stroke detection of AF and better implementation of present AF-guidelines with respect to anticoagulation therapy. | ||
| 650 | 4 | |a atrial fibrillation | |
| 650 | 4 | |a cardioembolic stroke | |
| 650 | 4 | |a CHA2DS2-VASc score | |
| 650 | 4 | |a CHADS2 score | |
| 650 | 4 | |a oral anticoagulation | |
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