Relationship Between CHADS2 Score and Ischemic Stroke During Rhythm Control Therapy for Paroxysmal Atrial Fibrillation
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- Komatsu Takashi
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
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- Tachibana Hideaki
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
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- Sato Yoshihiro
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
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- Ozawa Masato
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
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- Kunugida Fusanori
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
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- Orii Makoto
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
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- Nakamura Motoyuki
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine
書誌事項
- 公開日
- 2010
- 資源種別
- journal article
- DOI
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- 10.1536/ihj.51.24
- 公開者
- 一般社団法人 インターナショナル・ハート・ジャーナル刊行会
この論文をさがす
説明
The CHADS2 score has been proposed for stratifying patients with nonvalvular atrial fibrillation (NVAF) according to the risk of thromboembolism in the AHA/ACC/ESC guidelines. However, there is little information about its usefulness for predicting the long-term risk of ischemic stroke in Japanese patients with paroxysmal AF. We retrospectively evaluated the incidence of ischemic stroke and the efficacy of anticoagulant therapy in paroxysmal AF patients on rhythm control therapy who were stratified by their CHADS2 score. The subjects were 334 NVAF patients (229 men and 105 women, mean age, 68 ± 12 years, mean follow-up period, 60 ± 35 months) who were categorized into low risk (score 0), moderate risk (1 or 2), and high risk (3 or more) groups for thromboembolism.<br>The low, moderate, and high risk groups accounted for 34%, 50%, and 16% of the patients, respectively. Among 257 patients without warfarin therapy, the annual rate of symptomatic ischemic stroke was 0.6% in the score 0 group, 0.5% in the score 1 group, 3.1% in the score 2 group, and 9.6% in the score 3 or more group. Among 77 patients treated with warfarin (target PT-INR: 1.6-3.0), the stroke rate was 0% in the score 0 group, 0% in the score 1 group, 1.4% in the score 2 group, and 6.6% in the score 3 or more group. The annual rate of ischemic stroke was 0.88% in patients treated with warfarin versus 2.67% in those without warfarin, or a decrease in risk of 68% with warfarin (P < 0.01). In Japanese patients with paroxysmal AF, the CHADS2 score is useful for predicting the risk of ischemic stroke. Anticoagulant therapy is needed to prevent ischemic stroke in patients with paroxysmal AF, especially those who have a CHADS2 score of 2 or more.
収録刊行物
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- International Heart Journal
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International Heart Journal 51 (1), 24-29, 2010
一般社団法人 インターナショナル・ハート・ジャーナル刊行会
