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CHADS-VASc 评分预测颈动脉支架置入术患者临床结局的价值。

Usefulness of CHADS-VASc Score to predict clinical outcomes of patients undergoing carotid artery stenting.

机构信息

Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, Health Sciences University, Istanbul, Turkey.

, Istanbul, Turkey.

出版信息

Int J Cardiovasc Imaging. 2021 Mar;37(3):783-789. doi: 10.1007/s10554-020-02078-y. Epub 2020 Oct 24.

Abstract

The CHADS-VASc score predicts stroke and mortality risk in several cardiovascular diseases regardless of atrial fibrillation. In this study, we aimed to investigate the ability of CHADS-VASc score to predict in-hospital and long-term outcomes in patients undergoing carotid artery stenting (CAS). The study population included 558 patients undergoing CAS. The patients were stratified into three groups based on their CHADS-VASc scores [low (≤ 2, n = 123), moderate (3-5, n = 355) and high (6-8, n = 80)]. In-hospital and 3-year outcomes were compared between the groups. In-hospital rates of ipsilateral and major strokes and death were significantly different between the groups (1.6% vs. 3.9% vs. 16.2%; 1.6% vs. 4.5% vs. 16.2%; 0.8% vs. 3.1% vs. 13.8%, p < 0.001 for all, respectively). At 3 years of follow-up, rates of ipsilateral and major strokes and death were significantly increased in patients with highscore compared to those with moderate and low scores (1.6% vs. 5.8% vs. 13%, p = 0.005; 0.8% vs. 5.2% vs. 13%, p = 0.001; 1.6% vs. 8.4% vs. 15.9%; p = 0.002, respectively). After adjusting for multi-model Cox regression analysis, CHADS-VASc score persisted as an independent prognostic factor for mortality and major stroke in patients undergoing CAS. Higher CHADS-VASc score predicted increased risk of in-hospital and 3- year stroke and mortality in patients undergoing CAS.

摘要

CHADS-VASc 评分可预测几种心血管疾病(无论是否存在房颤)的卒中及死亡风险。本研究旨在探讨 CHADS-VASc 评分在颈动脉支架置入术(CAS)患者住院和长期预后中的预测能力。研究人群包括 558 例行 CAS 的患者。根据 CHADS-VASc 评分,患者被分为三组[低危(≤2 分,n=123)、中危(3-5 分,n=355)和高危(6-8 分,n=80)]。比较组间住院及 3 年结局。组间同侧和主要卒中和死亡的住院发生率差异有统计学意义(1.6% vs. 3.9% vs. 16.2%;1.6% vs. 4.5% vs. 16.2%;0.8% vs. 3.1% vs. 13.8%,均 p<0.001)。3 年随访时,与中危和低危评分患者相比,高危评分患者同侧和主要卒中和死亡的发生率显著增加(1.6% vs. 5.8% vs. 13%,p=0.005;0.8% vs. 5.2% vs. 13%,p=0.001;1.6% vs. 8.4% vs. 15.9%,p=0.002)。经多模型 Cox 回归分析校正后,CHADS-VASc 评分仍是 CAS 患者死亡和主要卒中的独立预后因素。CHADS-VASc 评分越高,预示着 CAS 患者住院及 3 年卒中及死亡风险越高。

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