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

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.