The Correlation Between CHADS₂ Scores And The Degree Of Cerebral Atherosclerosis And The Prognosis Of Stroke

Objective:To investigate the correlation between the quantity of cerebral arterial stenosis,the prognosis of stroke and the CHADS2 scores in patients with nonvalvular atrial fibrillation so as to further explore its pathogenesis and progression mechanisms.Methods:In this study, a total of 68 cases of consecutive ischemic stroke patients with nonvalvular atrial fibrillation(male/female=38/30 cases) were enrolled, all admitted in Ganzhou hospital affiliated of Nanchang university, from June 2013 to December2014. According to the CHADS2 scores, all patients with stroke were categorized into three groups: low-risk(a total of 15 cases), moderate-risk(35) and high-risk group(18). All patients with complete clinical data, including smoking, drinking,hyperlipidemia, peripheral vascular disease, coronary heart disease, the use of anticoagulant drugs, the admission NIHSS score, left atrial diameter, D-dimer,international standardization ratio, plasma fibrin, prothrombin time, partial blood coagulation time live enzymes, Hart type and the number of cerebral artery stenosis.Results:(1) There were statistic difference about the admission NIHSS score in different groups(P<0.05)(low-risk group 12.27 ± 6.26 vs. moderate-risk group 8.06 ± 4.51, p= 0.000; low-risk group 12.27 ± 6.26 vs. high-risk group 4.83 ± 1.86, P = 0.007;moderate-risk group 8.06 ± 4.51 vs. high-risk group 4.83 ± 1.86, P = 0.006).(2) There were positive correlation among patients’ CHADS2 score and the number of cerebral arterial stenosis(P<0.05)(R = 0.58, P = 0.58).(3) According to the Hart type, there was statistical difference in the definite embolic stroke category between the low-risk group and the moderate-risk group(40.0% vs. 14.3%, P = 0.044), as well as between the low-risk group and the high-risk group(40.0% vs. 14.3%, P = 0.049). There was statistical difference in the probable embolic stroke category between the low-risk group and the moderate-risk group(46.7% vs. 17.1%, P = 0.029), as well as between the low-risk and the high-risk group(46.7% vs. 5.6%, P = 0.046). There were statistic difference among different groups in the possible atherothrombotic stroke category(low-risk group 6.7% vs.moderate-risk group 40.0%, P = 0.028; low-risk group 6.7% vs. high-risk group66.6%, P = 0.000; moderate-risk group 40.0% vs. high-risk group 66.6%, P = 0.041).(4) There was statistic difference between the moderate-risk group and the high-risk group in the progressive stroke.(moderate-risk group 2.9% vs. high-risk group 22.2%, P = 0.022).Conclusion:(1) The CHADS2 score was closely related to the degree of cerebral artery stenosis, there was a positive correlation between patients’ CHADS2 score and the number of cerebral arterial stenosis.(2) The CHADS2 score was closely related to the Hart type, there was a negative correlation between patients’ CHADS2 score and the definite embolic stroke, while there was a positive correlation between patients’ CHADS2 score and the possible atherothrombotic stroke. Atherosclerosis may jointly participated in the happening of ischemic stroke.(3) The CHADS2 score had no significant correlation to the prognosis in patients with stroke, but the atherosclerosis may be involved in the subsequent development.