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BMC Neurology
Published in: BMC Neurology 1/2011

Open Access 01-12-2011 | Research article

The determinants of stroke phenotypes were different from the predictors (CHADS2 and CHA2DS2-VASc) of stroke in patients with atrial fibrillation: a comprehensive approach

Authors: Semi Oh, Suk Jae Kim, Soo-Kyoung Ryu, Gyeong-Moon Kim, Chin Sang Chung, Kwang Ho Lee, Oh Young Bang

Published in: BMC Neurology | Issue 1/2011

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Abstract

Background

Atrial fibrillation (AF) is a leading cause of fatal ischemic stroke. It was recently reported that international normalized ratio (INR) levels were associated with infarct volumes. However, factors other than INR levels that affect stroke phenotypes are largely unknown. Therefore, we evaluated the determinants of stroke phenotypes (pattern and volume) among patients with AF who were not adequately anticoagulated.

Methods

We analyzed data pertaining to consecutive AF patients admitted over a 6-year period with acute MCA territory infarcts. We divided the patients according to DWI (diffusion-weighted imaging) lesion volumes and patterns, and the relationship between stroke predictors (the CHADS2 and CHA2DS2-VASc score), systemic, and local factors and each stroke phenotype were then evaluated.

Results

The stroke phenotypes varied among 231 patients (admission INR median 1.06, interquartile range (IQR) 1.00-1.14). Specifically, (1) the DWI lesion volumes ranged from 0.04-338.62 ml (median 11.86 ml; IQR, 3.07-44.20 ml) and (2) 46 patients had a territorial infarct pattern, 118 had a lobar/deep pattern and 67 had a small scattered pattern. Multivariate testing revealed that the CHADS2 and CHA2DS2-VASc score were not related to either stroke phenotype. Additionally, the prior use of antiplatelet agents was not related to the stroke phenotypes. Congestive heart failure and diastolic dysfunction were not associated with stroke phenotypes.

Conclusions

The results of this study indicated that the determinants of stroke phenotypes were different from the predictors (i.e., CHADS2 and CHA2DS2-VASc score) of stroke in patients with AF.
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Metadata
Title
The determinants of stroke phenotypes were different from the predictors (CHADS2 and CHA2DS2-VASc) of stroke in patients with atrial fibrillation: a comprehensive approach
Authors
Semi Oh
Suk Jae Kim
Soo-Kyoung Ryu
Gyeong-Moon Kim
Chin Sang Chung
Kwang Ho Lee
Oh Young Bang
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2011
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-11-107

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