1.Impact of CHADS2 Score on Neurological Severity and Long-Term Outcome in Atrial Fibrillation-Related Ischemic Stroke.
Dohoung KIM ; Jong Won CHUNG ; Chi Kyung KIM ; Wi Sun RYU ; Eun Sun PARK ; Seung Hoon LEE ; Byung Woo YOON
Journal of Clinical Neurology 2012;8(4):251-258
BACKGROUND AND PURPOSE: The CHADS2 (an acronym for congestive heart failure, hypertension, age > or =75 years, diabetes mellitus, and prior stroke or transient ischemic attack or thromboembolism) score is a widely used system for estimating the risk of stroke in patients with atrial fibrillation. However, how the CHADS2 score is related to stroke severity and outcome in patients with strokes due to atrial fibrillation has not yet been elucidated. METHODS: We enrolled patients with atrial fibrillation who visited our stroke center within 7 days after the onset of acute ischemic stroke between October 2002 and September 2008. CHADS2 scores were categorized into three groups: 0 points, low risk; 1 or 2 points, intermediate risk; and 3-6 points, high risk. Poor neurological state was defined as follows: a National Institutes of Health Stroke Scale (NIHSS) score of > or =2, and a modified Rankin Scale (mRS) score of > or =3 at discharge. Mortality information was ascertained as at December 2008. RESULTS: A cohort of 298 patients with atrial-fibrillation-related stroke was included in this study. A high-risk CHADS2 score at admission was a powerful predictor of poor neurological outcome [for NIHSS: odds ratio (OR), 4.17; 95% confidence interval (CI), 1.76-9.87; for mRS: OR, 2.97; 95% CI, 1.23-7.16] after controlling for all possible confounders. In addition, a high-risk CHADS2 score was an independent predictor of all causes of death during the follow-up [hazard ratio (HR), 3.01; 95% CI, 1.18-7.65] and vascular death (HR, 12.25; 95% CI, 1.50-99.90). CONCLUSIONS: Although the CHADS2 score was originally designed to distinguish patients with a future risk of stroke, our study shows that it may also be used to predict poor neurological outcome after atrial-fibrillation-related stroke.
Atrial Fibrillation
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Cause of Death
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Cohort Studies
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Diabetes Mellitus
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Follow-Up Studies
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Heart Failure
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Humans
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Hypertension
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Ischemic Attack, Transient
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National Institutes of Health (U.S.)
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Odds Ratio
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Stroke
2.Influence of 3 Stigmas of Small Vessel Disease on FLAIR Change in Acute Ischemic Stroke: Case-Control Study.
Dohoung KIM ; Jihoon KANG ; Nayoung KIM ; Won Young NOH ; Min Uk JANG ; Beom Joon KIM ; Moon Ku HAN ; Cheolkyu JUNG ; Byung Se CHOI ; Jae Hyoung KIM ; Hee Joon BAE
Journal of the Korean Neurological Association 2013;31(3):165-172
BACKGROUND: Attempts have been made to use the signal changes of fluid-attenuated inversion recovery (FLAIR) MRI as "a tissue clock," defined as a surrogate marker of the tissue damage resulting from acute ischemic stroke. The evolution of FLAIR signals after stroke onset has never been fully explained solely by time. The aim of this study was to determine whether cerebral small-vessel disease (SVD) affects FLAIR changes following acute ischemic stroke. METHODS: Based on data from a prospective stroke registry, consecutive patients who were hospitalized to the stroke center within 12 hours of stroke onset between January 2004 and May 2011 and had occlusion of the major cerebral arteries in the anterior circulation, as evidenced by MR angiography, were enrolled. Cases with FLAIR changes and controls without FLAIR changes were matched according to the time elapsed from stroke onset to MR study. RESULTS: Among the 130 patients who met the eligibility criteria, 62 (47.7%) had FLAIR changes. The time interval between stroke onset and MR study differed significantly between those with and without FLAIR changes (5.2 hours vs. 3.0 hours). FLAIR changes were more common among males and smokers. Comparisons between cases and controls matched on a one-to-one basis did not reveal any difference in the three signs of cerebral SVD: white-matter hyperintensities, lacunae, and cerebral microbleeds. CONCLUSIONS: This study failed to find any data supporting the hypothesis that cerebral SVD affects FLAIR changes after acute ischemic stroke.
Angiography
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Biomarkers
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Case-Control Studies
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Cerebral Arteries
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Glycosaminoglycans
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Humans
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Male
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Prospective Studies
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Stroke
3.Etiologies and Vascular Risk Factors in Patients With Central Retinal Artery Occlusion Treated by Intra-Arterial Thrombolysis.
Jung Won SHIN ; Jin Heon JEONG ; Han Yeong JEONG ; Dohoung KIM ; Jangsup MOON ; Tae Jung KIM ; Jihoon KANG ; Jeong Ho HONG ; Se Joon WOO ; Cheolkyu JUNG ; O Ki KWON ; Hee Joon BAE ; Moon Ku HAN
Journal of the Korean Neurological Association 2012;30(4):377-378
No abstract available.
Humans
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Retinal Artery
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Retinal Artery Occlusion
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Risk Factors
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Stroke