Abstract
Ischemic stroke following coronary revascularization procedures remains one of the most potentially devastating complications. CHA2DS2-VASc score has been widely used for stroke risk stratification in AF patients. The aim of this nationwide study was to examine the association between the CHA2DS2-VASc score and ischemic stroke following coronary revascularization procedures. We identified patients undergoing coronary revascularization procedures, coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), using the electronic Hospitalization Summary Reports. Logistic regression models were applied to evaluate the association of CHA2DS2-VASc score with the risk of post-procedural ischemic stroke. We identified 54,714 patients undergoing CABG and 263,063 patients undergoing PCI from 2013 to 2015. The CHA2DS2-VASc score had a positive graded association with the risk of post-procedural ischemic stroke in both CABG and PCI (P for trend <0.001). The adjusted risk of post-procedural ischemic stroke increased by an estimated 122.4% (odds ratio [OR], 2.22; 95% confidence interval [CI], 2.11–2.35) and 34.7% (OR, 1.35; 95% CI, 1.31–1.39) for each additional 1 point in the CHA2DS2-VASc score in CABG and PCI, respectively. In conclusion, these findings suggested that CHA2DS2-VASc score was an independent predictor of the development of post-procedural ischemic stroke in patients undergoing CABG and PCI.
Highlights
Cardiovascular disease is the leading cause of death in the world, as well as in China[1, 2]
The aim of the present study, which was based on a multicenter national database, was to determine the association between CHA2DS2-VASc score and post-procedural ischemic stroke in patients undergoing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)
Patients with post-procedural ischemic stroke had a higher prevalence of comorbid conditions and a higher CHA2DS2-VASc score
Summary
Cardiovascular disease is the leading cause of death in the world, as well as in China[1, 2]. A recent meta-analysis of 6 contemporary randomized control trials including 5,673 patients with stable coronary artery disease who underwent PCI indicated that the incidence rate of post-procedural stroke was 2.0% at a weighted mean follow up of 55 months[8]. The specific association between CHA2DS2-VASc score and ischemic stroke following PCI has, to our knowledge, not been studied before. Better understanding of this association is important because PCI and CABG have different risk profiles and survival trajectories[6, 21]. The aim of the present study, which was based on a multicenter national database, was to determine the association between CHA2DS2-VASc score and post-procedural ischemic stroke in patients undergoing CABG and PCI
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