{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T05:29:51Z","timestamp":1738733391473,"version":"3.37.0"},"reference-count":14,"publisher":"Texas Heart Institute Journal","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Background:<\/jats:title>\n<jats:p>Although the prognostic value of the CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc (congestive heart failure, hypertension, age \u226575 years, diabetes mellitus, prior stroke or transient ischemic attack, vascular disease, age 65-74 years, and female sex) scoring system in patients with stroke has been explored in several studies, a research gap exists in its application, especially in patients without atrial fibrillation (AF).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods:<\/jats:title>\n<jats:p>This study investigated the association between CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score and prognosis at 1 year in patients with acute ischemic stroke (AIS) who do not have AF. A total of 993 patients with AIS but without AF were recruited between January 2019 and December 2022. Patients were categorized into high-risk (CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score, &gt;2; n = 424), moderate-risk (CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score, 2; n = 218), and low-risk (CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score, 0-1; n = 351) groups. The primary outcome was major adverse cardiac events (MACE) at 1 year after index AIS. Multivariate Cox regression analyses evaluated the prognostic value of CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc scores after controlling for potential confounding factors. A sensitivity analysis was performed based on 3 CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc groups generated using propensity score matching.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results:<\/jats:title>\n<jats:p>The rate of MACE during 12-month follow-up was statistically significantly higher (<jats:italic>P<\/jats:italic> &lt; .01) in patients with a CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score greater than 2 (34.7%) than in patients with a score of 2 (23.9%) or of 0 or 1 (14.8%). Multivariate Cox regression models indicated that, compared with a CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score of 0 or 1, the hazard ratio (HR) of MACE occurrence was 3.22 (95% CI, 1.93-5.37; <jats:italic>P<\/jats:italic> &lt; .01) for a CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score greater than 2 and 1.92 (95% CI, 1.24-2.98; <jats:italic>P<\/jats:italic> &lt; .01) for a CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score of 2. When included in the Cox regression model as a continuous variable, the CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score remained strongly associated with higher risks of MACE (HR, 1.19 [95% CI, 1.11-1.26]; <jats:italic>P<\/jats:italic> &lt; .01), all-cause mortality (HR, 1.14 [95% CI, 1.05-1.23]; <jats:italic>P<\/jats:italic> &lt; .01), and recurrent stroke (HR, 1.15 [95% CI, 1.06-1.256]; <jats:italic>P<\/jats:italic> &lt; .01). Sensitivity analyses based on populations generated by propensity score matching yielded similar results.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion:<\/jats:title>\n<jats:p>The CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score effectively predicts MACE in patients with AIS but without AF, providing more accurate risk stratification.<\/jats:p>\n<\/jats:sec>","DOI":"10.14503\/thij-24-8450","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:30:53Z","timestamp":1738715453000},"source":"Crossref","is-referenced-by-count":0,"title":["CHA2DS2-VASc Score Is Associated With Prognosis in Patients With Acute Ischemic Stroke Without Atrial Fibrillation"],"prefix":"10.14503","volume":"52","author":[{"given":"Mingjuan","family":"Song","sequence":"first","affiliation":[{"name":"School of Medicine, Jiangsu University, Jiangsu Province, China"},{"name":"Department of Neurology, Tinglin Hospital, Jinshan District, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shanghai Eighth People\u2019s Hospital, Xuhui District, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5628","reference":[{"issue":"1","key":"b1","series-title":"Sci Rep","first-page":"793","article-title":"CHA2DS2-VASc score in acute ischemic stroke with atrial fibrillation: results from the Clinical Research Collaboration for Stroke in Korea","volume":"11","author":"Lee HL","year":"2021","unstructured":"Lee HL, Kim JT, Lee JS, et al. CHA2DS2-VASc score in acute ischemic stroke with atrial fibrillation: results from the Clinical Research Collaboration for Stroke in Korea. Sci Rep. 2021;11(1):793. doi:10.1038\/s41598-020-80874-1"},{"issue":"1","key":"b2","series-title":"Stroke","first-page":"53","article-title":"Long-term survival and function after stroke: a longitudinal observational study from the Swedish Stroke Register","volume":"50","author":"Sennf\u00e4lt S","year":"2019","unstructured":"Sennf\u00e4lt S, Norrving B, Petersson J, Ullberg T. Long-term survival and function after stroke: a longitudinal observational study from the Swedish Stroke Register. 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