{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:35:48Z","timestamp":1793316948978,"version":"4.5.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Justus-Liebig-Universit\u00e4t Gie\u00dfen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurol Belg"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The 2024 ESC atrial fibrillation guidelines introduced the CHA\u2082DS\u2082-VA score by removing female sex as an independent risk criterion. Although intended to simplify risk stratification and avoid sex-based overtreatment, the real-world implications for women who present with AF-related ischemic stroke\/TIA remain unclear. In this prospective observational study, we examined the clinical implications of CHA\u2082DS\u2082-VA recalibration in a post-stroke setting, focusing on sex-specific differences in stroke severity and early functional outcome, and on the proportion of women who newly fall below the anticoagulation threshold (score\u2009\u2264\u20091).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a prospective cohort of 714 consecutive stroke patients, 161 (22.5%) had documented AF. Risk stratification was performed using both CHA\u2082DS\u2082-VASc and the revised CHA\u2082DS\u2082-VA score. Stroke severity (NIHSS) and functional outcome (mRS) were analyzed by sex. Propensity score matching and multivariable logistic regression were used to examine the independent association between sex and stroke severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Female patients with AF were older and had a higher vascular risk burden than men. They presented with significantly more severe strokes (median NIHSS 12 vs. 8;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01) and tended toward worse outcomes. After score recalibration, 11 of 81 women (13.6%) had a CHA\u2082DS\u2082-VA score\u2009\u2264\u20091, falling below the ESC anticoagulation threshold\u2014despite having experienced an ischemic stroke. Most of these patients had cardioembolic strokes and moderate-to-severe neurological deficits. In matched analyses, female sex remained independently associated with severe stroke (aOR 1.54, 95% CI 1.03\u20132.29).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this prospective cohort of AF-related ischemic stroke, women had greater comorbidity burden and higher stroke severity than men. A subgroup with CHA\u2082DS\u2082-VA\u2009\u2264\u20091 nonetheless sustained ischemic stroke, and exploratory 5-year follow-up suggested excess recurrence without anticoagulation. These findings require validation in larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s13760-025-02916-7","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T15:01:34Z","timestamp":1760367694000},"page":"1653-1662","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical implications of the recalibrated CHA\u2082DS\u2082-VA score for women after ischemic stroke: a prospective cohort study"],"prefix":"10.1007","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0534-132X","authenticated-orcid":false,"given":"Priyanka","family":"Boettger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamschid","family":"Sedighi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Piayda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Juenemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar Alhaj","family":"Omar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Unsoeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Sossalla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Buerke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"2916_CR1","doi-asserted-by":"publisher","first-page":"1468","DOI":"10.1093\/europace\/euz141","volume":"21","author":"A Di Carlo","year":"2019","unstructured":"Di Carlo A, Bellino L, Consoli D, Mori F, Zaninelli A, Baldereschi M, Cattarinussi A, D\u2019Alfonso MG, Gradia C, Sgherzi B et al (2019) Prevalence of atrial fibrillation in the Italian elderly population and projections from 2020 to 2060 for Italy and the European union: the FAI project. 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