Relationship between CHA2DS2-VASc score and echocardiography parameters with ischemic stroke development

Abstract

Context: Atrial fibrillation (AF) is the most common persistent rhythm disorder that has been shown to be associated with a significant increase in stroke risk. CHA2DS2-VASc is a scoring system to identify the risk of thromboembolism in nonvalvular AF patients. Aims: The aim of our study was to investigate the relationship between the demographic properties, transthoracic and transesophageal echocardiography parameters, the patients' CHA2DS2-VASc scores, and cerebrovascular events. Subjects and Methods: There were 48 patients with previous stroke and 217 patients without. We compared patients' demographic data, echocardiographic parameters, presence of patent foramen ovale (PFO) in transesophageal echocardiography, medications, AF categories, and CHA2DS2-VASc scores. Results: The mean age of the stroke group was 64.8 ± 12.3 years; the mean age of the control group was 63.2 ± 12.8 years (P = 0.417). The CHA2DS2-VASc score was 3.25 ± 2.06 in the stroke group and 2.49 ± 1.54 in the nonstroke group (P < 0.001). As for the presence of PFO, it was present in 45.8% of patients who had a stroke, but only 17.9% in the nonstroke group (P < 0.001). Conclusions: CHA2DS2-VASc score increases the risk of stroke in a broader sense, but not only in patients with AF. It is reasonable to think that the higher the score, the higher the risk of stroke. Furthermore, the presence of PFO in a patient is a facilitating factor for stroke, which may be considered for closure in the case of recurrent stroke episodes.

Keywords

• anticoagulants
• atrial fibrillation
• stroke
• thrombus