CHADS2 score predicts functional outcome of stroke in patients with a history of coronary artery disease

Abstract

Background: The aim of this study was to evaluate the efficacy of the CHADS2 scoring system as a prognostic tool for stroke patients with a prior history of coronary artery disease (CAD).

Methods: We enrolled 148 acute ischemic stroke patients (mean age, 74.2 years; males, 77.0%) with a history of CAD. Pre-admission CHADS2 scores were calculated by assigning a single point for the presence of congestive heart failure, hypertension, age ≥75 years, and diabetes; and assigning 2 points for a prior history of stroke or transient ischemic attack. Comparisons were made between patients with poor and good 3-month functional outcomes. A multivariate logistic regression analysis was performed to assess the predictive value of CHADS2 scores for poor outcome.

Results: The patients with poor and good outcomes displayed significant differences in CHADS2 scores (median, 3 vs. 2, P=0.014), carotid artery stenosis (41.0% vs. 24.6%, P=0.037), intracranial artery stenosis (32.5% vs. 15.4%, P=0.017), atrial fibrillation (31.3% vs. 16.9%, P=0.045), and admission NIHSS score (median, 11 vs. 5, P<0.001). The CHADS2 score was an independent determinant of poor functional outcome on a multivariate analysis (per 1 point increase: OR 1.47, 95% CI 1.05-2.11, P=0.025; CHADS2 score ≥3: OR 1.58, 95% CI 1.01-2.54, P=0.050).

Conclusions: The CHADS2 score is a potential useful tool for predicting functional outcome in stroke patients with a history of CAD.

Keywords: CHADS(2) score; Coronary artery disease; Functional outcome; Polyvascular disease; Prognosis; Stroke.