Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS(2) , CHA(2) DS(2) -VASc score, underuse of oral anticoagulation, and implications for preventive measures

F Palm; T Kleemann; M Dos Santos; C Urbanek; F Buggle; A Safer; M G Hennerici; H Becher; R Zahn; A J Grau

doi:10.1111/j.1468-1331.2012.03804.x

Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS(2) , CHA(2) DS(2) -VASc score, underuse of oral anticoagulation, and implications for preventive measures

Standard

Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS(2) , CHA(2) DS(2) -VASc score, underuse of oral anticoagulation, and implications for preventive measures. / Palm, F; Kleemann, T; Dos Santos, M; Urbanek, C; Buggle, F; Safer, A; Hennerici, M G; Becher, H; Zahn, R; Grau, A J.

in: EUR J NEUROL, Jahrgang 20, Nr. 1, 01.01.2013, S. 117-23.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Palm, F, Kleemann, T, Dos Santos, M, Urbanek, C, Buggle, F, Safer, A, Hennerici, MG, Becher, H, Zahn, R & Grau, AJ 2013, 'Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS(2) , CHA(2) DS(2) -VASc score, underuse of oral anticoagulation, and implications for preventive measures', EUR J NEUROL, Jg. 20, Nr. 1, S. 117-23. https://doi.org/10.1111/j.1468-1331.2012.03804.x

APA

Palm, F., Kleemann, T., Dos Santos, M., Urbanek, C., Buggle, F., Safer, A., Hennerici, M. G., Becher, H., Zahn, R., & Grau, A. J. (2013). Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS(2) , CHA(2) DS(2) -VASc score, underuse of oral anticoagulation, and implications for preventive measures. EUR J NEUROL, 20(1), 117-23. https://doi.org/10.1111/j.1468-1331.2012.03804.x

Vancouver

Palm F, Kleemann T, Dos Santos M, Urbanek C, Buggle F, Safer A et al. Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS(2) , CHA(2) DS(2) -VASc score, underuse of oral anticoagulation, and implications for preventive measures. EUR J NEUROL. 2013 Jan 1;20(1):117-23. https://doi.org/10.1111/j.1468-1331.2012.03804.x

Bibtex

@article{83cb81fd978942d0a3abe6becb5dde98,

title = "Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS(2) , CHA(2) DS(2) -VASc score, underuse of oral anticoagulation, and implications for preventive measures",

abstract = "BACKGROUND AND PURPOSE: Atrial fibrillation (AF) is amongst the most important etiologies of ischaemic stroke. In a population-based stroke registry, we tested the hypothesis of low adherence to current guidelines as a main cause of high rates of AF-associated stroke.METHODS: Within the Ludwigshafen Stroke Study (LuSSt), a prospective ongoing population-based stroke register, we analyzed all patients with a first-ever ischaemic stroke (FEIS) owing to AF in 2006 and 2007. We determined whether AF was diagnosed before stroke and assessed pre-stroke CHADS(2) and CHA(2) DS(2) -VASc scores.RESULTS: In total, 187 of 626 patients with FEIS suffered from cardioembolic stroke owing to AF, which was newly diagnosed in 57 (31%) patients. Retrospective pre-stroke risk stratification according to CHADS(2) score indicated low/intermediate risk in 34 patients (18%) and high risk (CHADS(2) ≥ 2) in 153 patients (82%). Application of CHA(2) DS(2) -VASc score reduced number of patients at low/intermediate risk (CHA(2) DS(2) -VASc score 0-1) to five patients (2.7%). In patients with a CHADS(2) score ≥ 2 and known AF (n = 106) before stroke, 38 (36%) were on treatment with vitamin K antagonists on admission whilst only in 16 patients (15%) treatment was in therapeutic range.CONCLUSIONS: Our study strongly supports the hypothesis that underuse of oral anticoagulants in high-risk patients importantly contributes to AF-associated stroke. CHA(2) DS(2) -VASc score appears to be a more valuable risk stratification tool than CHADS(2) score. Preventive measures should focus on optimizing pre-stroke detection of AF and better implementation of present AF-guidelines with respect to anticoagulation therapy.",

keywords = "Age Factors, Aged, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Chi-Square Distribution, Community Health Planning, Female, Humans, Male, Middle Aged, Prospective Studies, Registries, Retrospective Studies, Severity of Illness Index, Stroke",

author = "F Palm and T Kleemann and {Dos Santos}, M and C Urbanek and F Buggle and A Safer and Hennerici, {M G} and H Becher and R Zahn and Grau, {A J}",

note = "{\textcopyright} 2012 The Author(s) European Journal of Neurology {\textcopyright} 2012 EFNS.",

year = "2013",

month = jan,

day = "1",

doi = "10.1111/j.1468-1331.2012.03804.x",

language = "English",

volume = "20",

pages = "117--23",

journal = "EUR J NEUROL",

issn = "1351-5101",

publisher = "Wiley-Blackwell",

number = "1",

}

RIS

TY - JOUR

T1 - Stroke due to atrial fibrillation in a population-based stroke registry (Ludwigshafen Stroke Study) CHADS(2) , CHA(2) DS(2) -VASc score, underuse of oral anticoagulation, and implications for preventive measures

AU - Palm, F

AU - Kleemann, T

AU - Dos Santos, M

AU - Urbanek, C

AU - Buggle, F

AU - Safer, A

AU - Hennerici, M G

AU - Becher, H

AU - Zahn, R

AU - Grau, A J

PY - 2013/1/1

Y1 - 2013/1/1

N2 - BACKGROUND AND PURPOSE: Atrial fibrillation (AF) is amongst the most important etiologies of ischaemic stroke. In a population-based stroke registry, we tested the hypothesis of low adherence to current guidelines as a main cause of high rates of AF-associated stroke.METHODS: Within the Ludwigshafen Stroke Study (LuSSt), a prospective ongoing population-based stroke register, we analyzed all patients with a first-ever ischaemic stroke (FEIS) owing to AF in 2006 and 2007. We determined whether AF was diagnosed before stroke and assessed pre-stroke CHADS(2) and CHA(2) DS(2) -VASc scores.RESULTS: In total, 187 of 626 patients with FEIS suffered from cardioembolic stroke owing to AF, which was newly diagnosed in 57 (31%) patients. Retrospective pre-stroke risk stratification according to CHADS(2) score indicated low/intermediate risk in 34 patients (18%) and high risk (CHADS(2) ≥ 2) in 153 patients (82%). Application of CHA(2) DS(2) -VASc score reduced number of patients at low/intermediate risk (CHA(2) DS(2) -VASc score 0-1) to five patients (2.7%). In patients with a CHADS(2) score ≥ 2 and known AF (n = 106) before stroke, 38 (36%) were on treatment with vitamin K antagonists on admission whilst only in 16 patients (15%) treatment was in therapeutic range.CONCLUSIONS: Our study strongly supports the hypothesis that underuse of oral anticoagulants in high-risk patients importantly contributes to AF-associated stroke. CHA(2) DS(2) -VASc score appears to be a more valuable risk stratification tool than CHADS(2) score. Preventive measures should focus on optimizing pre-stroke detection of AF and better implementation of present AF-guidelines with respect to anticoagulation therapy.

AB - BACKGROUND AND PURPOSE: Atrial fibrillation (AF) is amongst the most important etiologies of ischaemic stroke. In a population-based stroke registry, we tested the hypothesis of low adherence to current guidelines as a main cause of high rates of AF-associated stroke.METHODS: Within the Ludwigshafen Stroke Study (LuSSt), a prospective ongoing population-based stroke register, we analyzed all patients with a first-ever ischaemic stroke (FEIS) owing to AF in 2006 and 2007. We determined whether AF was diagnosed before stroke and assessed pre-stroke CHADS(2) and CHA(2) DS(2) -VASc scores.RESULTS: In total, 187 of 626 patients with FEIS suffered from cardioembolic stroke owing to AF, which was newly diagnosed in 57 (31%) patients. Retrospective pre-stroke risk stratification according to CHADS(2) score indicated low/intermediate risk in 34 patients (18%) and high risk (CHADS(2) ≥ 2) in 153 patients (82%). Application of CHA(2) DS(2) -VASc score reduced number of patients at low/intermediate risk (CHA(2) DS(2) -VASc score 0-1) to five patients (2.7%). In patients with a CHADS(2) score ≥ 2 and known AF (n = 106) before stroke, 38 (36%) were on treatment with vitamin K antagonists on admission whilst only in 16 patients (15%) treatment was in therapeutic range.CONCLUSIONS: Our study strongly supports the hypothesis that underuse of oral anticoagulants in high-risk patients importantly contributes to AF-associated stroke. CHA(2) DS(2) -VASc score appears to be a more valuable risk stratification tool than CHADS(2) score. Preventive measures should focus on optimizing pre-stroke detection of AF and better implementation of present AF-guidelines with respect to anticoagulation therapy.

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Anticoagulants

KW - Atrial Fibrillation

KW - Chi-Square Distribution

KW - Community Health Planning

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Registries

KW - Retrospective Studies

KW - Severity of Illness Index

KW - Stroke

U2 - 10.1111/j.1468-1331.2012.03804.x

DO - 10.1111/j.1468-1331.2012.03804.x

M3 - SCORING: Journal article

C2 - 22788384

VL - 20

SP - 117

EP - 123

JO - EUR J NEUROL

JF - EUR J NEUROL

SN - 1351-5101

IS - 1

ER -