Association between CHADS2, CHA2DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Functional Outcomes in Acute Ischemic Stroke Patients Who Received Endovascular Thrombectomy

Background: CHADS2, CHA2DS2-VASc, ATRIA, and Essen stroke risk scores are used to estimate thromboembolism risk. We aimed to investigate the association between unfavorable outcomes and stroke risk scores in patients who received endovascular thrombectomy (EVT). Methods: This study was performed using data from a nationwide, multicenter registry to explore the selection criteria for patients who would benefit from reperfusion therapies. We calculated pre-admission CHADS2, CHA2DS2-VASc, ATRIA, and Essen scores for each patient who received EVT and compared the relationship between these scores and 3-month modified Rankin Scale (mRS) records. Results: Among the 404 patients who received EVT, 213 (52.7%) patients had unfavorable outcomes (mRS 3–6). All scores were significantly higher in patients with unfavorable outcomes than in those with favorable outcomes. Multivariable logistic regression analysis indicated that CHADS2 and the ATRIA score were positively correlated with unfavorable outcomes after adjusting for body mass index and variables with p < 0.1 in the univariable analysis (CHADS2 score: odds ratio [OR], 1.484; 95% confidence interval [CI], 1.290–1.950; p = 0.005, ATRIA score, OR, 1.128; 95% CI, 1.041–1.223; p = 0.004). Conclusions: The CHADS2 and ATRIA scores were positively correlated with unfavorable outcomes and could be used to predict unfavorable outcomes in patients who receive EVT.

[1]  Dong Joon Kim,et al.  Association between CHADS2, CHA2DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients , 2022, Journal of clinical medicine.

[2]  Dong Joon Kim,et al.  Prediction of Early Recanalization after Intravenous Thrombolysis in Patients with Large-Vessel Occlusion , 2021, Journal of stroke.

[3]  Dong Joon Kim,et al.  Immediate and Long-Term Outcomes of Reperfusion Therapy in Patients With Cancer , 2021, Stroke.

[4]  Dong Joon Kim,et al.  Comorbidity index for predicting mortality at 6 months after reperfusion therapy , 2021, Scientific Reports.

[5]  Zhiming Zhou,et al.  Blood pressure variability and outcomes after mechanical thrombectomy based on the recanalization and collateral status , 2021, Therapeutic advances in neurological disorders.

[6]  Dong Joon Kim,et al.  Improving the Clinical Outcome in Stroke Patients Receiving Thrombolytic or Endovascular Treatment in Korea: from the SECRET Study , 2020, Journal of clinical medicine.

[7]  Correction to: Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. , 2019, Stroke.

[8]  W. Powers,et al.  Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. , 2019, Stroke.

[9]  H. Katki Quantifying risk stratification provided by diagnostic tests and risk predictions: Comparison to AUC and decision curve analysis , 2019, Statistics in medicine.

[10]  S. Kwon,et al.  2019 Update of the Korean Clinical Practice Guidelines of Stroke for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke , 2019, Journal of stroke.

[11]  Heather B. Roesly Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging , 2018, The Journal of Emergency Medicine.

[12]  G. Hankey,et al.  Early Prediction of Poor Outcome Despite Successful Recanalization After Endovascular Treatment for Anterior Large Vessel Occlusion Stroke. , 2018, World neurosurgery.

[13]  Ximing Nie,et al.  Futile Recanalization after Endovascular Therapy in Acute Ischemic Stroke , 2018, BioMed research international.

[14]  E. Lindsay Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct , 2018 .

[15]  A. Padovani,et al.  Leukoaraiosis is a predictor of futile recanalization in acute ischemic stroke , 2017, Journal of Neurology.

[16]  Matteo Bottai,et al.  Comparison of the ATRIA, CHADS2, and CHA2DS2-VASc stroke risk scores in predicting ischaemic stroke in a large Swedish cohort of patients with atrial fibrillation. , 2016, European heart journal.

[17]  Hyuk-Jae Chang,et al.  Association between Aortic Atheroma and Cerebral Small Vessel Disease in Patients with Ischemic Stroke , 2016, Journal of stroke.

[18]  C. Chung,et al.  Update of the Korean Clinical Practice Guidelines for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke , 2016, Journal of stroke.

[19]  O. Kwon,et al.  Recanalization Rate and Clinical Outcome in Acute Carotid-T Occlusion , 2015, European Neurology.

[20]  H. Diener,et al.  Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. , 2015, The New England journal of medicine.

[21]  A. Demchuk,et al.  Thrombectomy within 8 hours after symptom onset in ischemic stroke. , 2015, The New England journal of medicine.

[22]  Ertugrul Colak,et al.  Predictors of a Good Outcome after Endovascular Stroke Treatment with Stent Retrievers , 2015, TheScientificWorldJournal.

[23]  Min-Jeong Shin,et al.  Low levels of plasma omega 3-polyunsaturated fatty acids are associated with cerebral small vessel diseases in acute ischemic stroke patients. , 2015, Nutrition research.

[24]  M. Krause,et al.  Endovascular therapy for ischemic stroke with perfusion-imaging selection. , 2015, The New England journal of medicine.

[25]  Eric E. Smith,et al.  Randomized assessment of rapid endovascular treatment of ischemic stroke. , 2015, The New England journal of medicine.

[26]  Hester F. Lingsma,et al.  A randomized trial of intraarterial treatment for acute ischemic stroke. , 2015, The New England journal of medicine.

[27]  F. Sallustio,et al.  Thrombectomy within 8 hours after symptom onset in ischemic stroke , 2015 .

[28]  Jinkwon Kim,et al.  Distribution of Cerebral Microbleeds Determines Their Association with Impaired Kidney Function , 2014, Journal of clinical neurology.

[29]  Y. D. Kim,et al.  The distribution of cerebral microbleeds determines their association with arterial stiffness in non‐cardioembolic acute stroke patients , 2014, European journal of neurology.

[30]  H. Lee,et al.  The association between asymptomatic coronary artery disease and CHADS2 and CHA2DS2‐VASc scores in patients with stroke , 2013, European journal of neurology.

[31]  Pierre Amarenco,et al.  Diabetes Mellitus, Admission Glucose, and Outcomes After Stroke Thrombolysis: A Registry and Systematic Review , 2013, Stroke.

[32]  Daniel E. Singer,et al.  A New Risk Scheme to Predict Ischemic Stroke and Other Thromboembolism in Atrial Fibrillation: The ATRIA Study Stroke Risk Score , 2013, Journal of the American Heart Association.

[33]  Jinkwon Kim,et al.  Low ankle-brachial index is an independent predictor of poor functional outcome in acute cerebral infarction. , 2012, Atherosclerosis.

[34]  Jinkwon Kim,et al.  Increases in Cerebral Atherosclerosis According to CHADS2 Scores in Patients With Stroke With Nonvalvular Atrial Fibrillation , 2011, Stroke.

[35]  A. Qureshi,et al.  Occurrence and Predictors of Futile Recanalization following Endovascular Treatment among Patients with Acute Ischemic Stroke: A Multicenter Study , 2010, American Journal of Neuroradiology.

[36]  Gregory Y H Lip,et al.  Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. , 2010, Chest.

[37]  S. Schwab,et al.  Malignant middle cerebral artery infarction: clinical characteristics, treatment strategies, and future perspectives , 2009, The Lancet Neurology.

[38]  Deepak L. Bhatt,et al.  The Essen Stroke Risk Score Predicts Recurrent Cardiovascular Events: A Validation Within the REduction of Atherothrombosis for Continued Health (REACH) Registry , 2009, Stroke.

[39]  M. Rich,et al.  Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. , 2001, JAMA.

[40]  Martha J. Radford,et al.  Validation of Clinical Classification Schemes for Predicting Stroke: Results From the National Registry of Atrial Fibrillation , 2001 .