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Use of CHA2DS2-VASc score to predict the risk of ischemic stroke and mortality in patients who underwent coronary artery bypass grafting surgery: a retrospective cohort study.

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OBJECTIVE Ischemic stroke and postoperative atrial fibrillation (POAF) are frequently seen after coronary artery bypass grafting (CABG). CHA2DS2-VASc scoring system is used to predict ischemic stroke and POAF. This study… Click to show full abstract

OBJECTIVE Ischemic stroke and postoperative atrial fibrillation (POAF) are frequently seen after coronary artery bypass grafting (CABG). CHA2DS2-VASc scoring system is used to predict ischemic stroke and POAF. This study aimed to evaluate CHA2DS2-VASc scores in predicting ischemic stroke after CABG and analyze the effect of POAF on the relationship between CHA2DS2-VASc scores and ischemic stroke. PATIENTS AND METHODS Demographic and clinical characteristics of patients who underwent CABG were retrospectively recorded. CHA2DS2-VASc score was calculated for each patient and stratified into low- and high-risk groups. The heart rhythm of the patients was monitored during in-hospital follow-up and ischemic stroke was evaluated. Ischemic stroke and POAF were the primary and secondary outcomes. RESULTS There were 383 patients (mean age of 63.1 ± 10.4 years). Ischemic stroke developed in eight (2.1%) patients. There were 248 (64.8%) high-risk patients with CHA2DS2-VASc scores. Patients with ischemic stroke were significantly older (p = 0.021) and had higher CHA2DS2-VASc scores (p < 0.001). Low and high-risk groups did not reveal any significant difference for ischemic stroke (p = 0.055). There were 56 (14.7%) patients with POAF. The relationship between CHA2DS2-VASc scores and ischemic stroke was not affected by POAF (p = 0.739). CHA2DS2-VASc scores of ≥3 predicted ischemic stroke (p < 0.001) with 100% sensitivity and 64.5% specificity. CONCLUSIONS Ischemic stroke was associated with a higher mortality risk after CABG. Higher CHA2DS2-VASc scores were associated with higher ischemic stroke risk. POAF did not significantly affect the relationship between CHA2DS2-VASc scores and ischemic stroke. CHA2DS2-VASc score can be used to predict ischemic stroke and mortality following CABG.

Keywords: vasc scores; ischemic stroke; cha2ds2 vasc

Journal Title: European review for medical and pharmacological sciences
Year Published: 2023

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