Kim Hyung Jun, Park Moo-Seok, Yoo Joonsang, Kim Young Dae, Park Hyungjong, Kim Byung Moon, Bang Oh Young, Kim Hyeon Chang, Han Euna, Kim Dong Joon, Heo JoonNyung, Choi Jin Kyo, Lee Kyung-Yul, Lee Hye Sun, Shin Dong Hoon, Choi Hye-Yeon, Sohn Sung-Il, Hong Jeong-Ho, Lee Jong Yun, Baek Jang-Hyun, Kim Gyu Sik, Seo Woo-Keun, Chung Jong-Won, Kim Seo Hyun, Han Sang Won, Park Joong Hyun, Kim Jinkwon, Jung Yo Han, Cho Han-Jin, Ahn Seong Hwan, Lee Sung Ik, Seo Kwon-Duk, Chang Yoonkyung, Song Tae-Jin, Nam Hyo Suk
Department of Neurology, Seoul Hospital, College of Medicine, Ewha Woman's University, Seoul 07804, Korea.
Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea.
J Clin Med. 2022 Jan 5;11(1):274. doi: 10.3390/jcm11010274.
The CHADS, CHADS-VASc, ATRIA, and Essen scores have been developed for predicting vascular outcomes in stroke patients. We investigated the association between these stroke risk scores and unsuccessful recanalization after endovascular thrombectomy (EVT).
From the nationwide multicenter registry (Selection Criteria in Endovascular Thrombectomy and Thrombolytic therapy (SECRET)) (Clinicaltrials.gov NCT02964052), we consecutively included 501 patients who underwent EVT. We identified pre-admission stroke risk scores in each included patient.
Among 501 patients who underwent EVT, 410 (81.8%) patients achieved successful recanalization (mTICI ≥ 2b). Adjusting for body mass index and < 0.1 in univariable analysis revealed the association between all stroke risk scores and unsuccessful recanalization (CHADS score: odds ratio (OR) 1.551, 95% confidence interval (CI) 1.198-2.009, = 0.001; CHADSVASc score: OR 1.269, 95% CI 1.080-1.492, = 0.004; ATRIA score: OR 1.089, 95% CI 1.011-1.174, = 0.024; and Essen score: OR 1.469, 95% CI 1.167-1.849, = 0.001). The CHADS score had the highest AUC value and differed significantly only from the Essen score (AUC of CHADS score; 0.618, 95% CI 0.554-0.681).
All stroke risk scores were associated with unsuccessful recanalization after EVT. Our study suggests that these stroke risk scores could be used to predict recanalization in stroke patients undergoing EVT.
CHADS、CHADS-VASc、ATRIA和Essen评分已被用于预测卒中患者的血管结局。我们研究了这些卒中风险评分与血管内血栓切除术（EVT）后再通失败之间的关联。
从全国多中心注册研究（血管内血栓切除术和溶栓治疗的选择标准（SECRET））（Clinicaltrials.gov NCT02964052）中，我们连续纳入了501例行EVT的患者。我们确定了每个纳入患者入院前的卒中风险评分。
在501例行EVT的患者中，410例（81.8%）患者实现了成功再通（改良脑梗死溶栓分级（mTICI）≥2b）。在单变量分析中，调整体重指数后，所有卒中风险评分与再通失败之间的关联均<0.1（CHADS评分：比值比（OR）1.551，95%置信区间（CI）1.198-2.009，P = 0.001；CHADS-VASc评分：OR 1.269，95%CI 1.080-1.492，P = 0.004；ATRIA评分：OR 1.089，95%CI 1.011-1.174，P = 0.024；Essen评分：OR 1.469，95%CI 1.167-1.849，P = 0.001）。CHADS评分的曲线下面积（AUC）值最高，且仅与Essen评分有显著差异（CHADS评分的AUC；0.618，95%CI 0.554-0.681）。
所有卒中风险评分均与EVT后再通失败相关。我们的研究表明，这些卒中风险评分可用于预测接受EVT的卒中患者的再通情况。
