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CHA2DS2-VASc 风险评分可预测急性缺血性脑卒中患者血管内治疗的成功。

The CHA2DS2-VASc risk score predicts successful endovascular treatment in patients with acute ischemic stroke.

机构信息

Department of Cardiology, Malatya Training and Research Hospital, Malatya, Turkey.

Department of Neurology, Malatya Training and Research Hospital, Malatya, Turkey.

出版信息

Acta Neurol Scand. 2022 Apr;145(4):407-413. doi: 10.1111/ane.13564. Epub 2021 Dec 4.

Abstract

OBJECTIVES

Acute ischemic stroke is a common cause of mortality and morbidity worldwide. Percutaneous endovascular intervention is an important treatment method in ischemic stroke. Endovascular procedure success is associated with the clinical outcome of the patients. The CHA2DS2-VASC score is an important score used to determine the risk of ischemic stroke in patients with atrial fibrillation. In our study, we aimed to evaluate the relationship between procedure success and CHA2DS2-VASC score in patients with acute ischemic stroke who underwent endovascular intervention.

MATERIALS AND METHODS

A total of 102 consecutive patients who underwent endovascular intervention with acute ischemic stroke were included in the study. The admission CHA2DS2-VASc scores of the patients were recorded. After the procedure, the relationship between the TICI score and the CHA2DS2-VASc score was evaluated.

RESULTS

CHA2DS2-VASc score was significantly higher in the group that resulted in unsuccessful endovascular intervention (2.78 ± 1.44, 5.02 ± 1.77 p < .001). Receiver-operating characteristics analysis revealed the cutoff value of CHA2DS2-VASc score ≥3 as a predictor of unsuccessful intervention with 76,6% sensitivity and 83,3% specificity, positive predictive value 50%, negative predictive value 84,6% (area under the curve [AUC]: 0.827,95% CI: 0.739-0.895, p < .001). In the multivariate analysis; atrial fibrillation ([β] = 4.201; [CI]: 1.251-14.103, p = .020), CHA2DS2-VASc score ([β] = 0.053; [CI]: 0.004-0.750, p = .030) were found independent predictors for unsuccessful intervention treatment.

CONCLUSIONS

In our study, we showed that the CHA2DS2-VASc score is associated with the success of endovascular intervention in patients with acute ischemic stroke who underwent percutaneous endovascular treatment.

摘要

目的

急性缺血性脑卒中是全球范围内导致死亡率和发病率的常见原因。经皮腔内血管介入治疗是缺血性脑卒中的重要治疗方法。血管内操作的成功与患者的临床结局相关。CHA2DS2-VASC 评分是用于确定房颤患者发生缺血性脑卒中风险的重要评分。在本研究中,我们旨在评估接受血管内介入治疗的急性缺血性脑卒中患者中,操作成功与 CHA2DS2-VASC 评分之间的关系。

材料和方法

共纳入 102 例接受血管内介入治疗的急性缺血性脑卒中患者。记录患者入院时的 CHA2DS2-VASc 评分。在操作后,评估 TICI 评分与 CHA2DS2-VASc 评分之间的关系。

结果

血管内操作不成功组的 CHA2DS2-VASc 评分显著较高(2.78±1.44,5.02±1.77,p<0.001)。受试者工作特征分析显示,CHA2DS2-VASc 评分≥3 作为血管内操作不成功的预测因子,具有 76.6%的灵敏度和 83.3%的特异性、50%的阳性预测值、84.6%的阴性预测值(曲线下面积 [AUC]:0.827,95%CI:0.739-0.895,p<0.001)。多变量分析显示,房颤([β]=4.201;[CI]:1.251-14.103,p=0.020)和 CHA2DS2-VASc 评分([β]=0.053;[CI]:0.004-0.750,p=0.030)是血管内操作不成功的独立预测因子。

结论

在本研究中,我们表明 CHA2DS2-VASc 评分与接受经皮腔内血管介入治疗的急性缺血性脑卒中患者的血管内操作成功相关。

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