Ischemic Stroke Risk in Patients With Atrial Fibrillation and CHA2DS2-VASc Score of 1: Systematic Review and Meta-Analysis.

Abstract:

BACKGROUND AND PURPOSE:The CHA2DS2-VASc score aims to improve risk stratification of ischemic stroke among patients with atrial fibrillation to identify those who can safely forego oral anticoagulation. Oral anticoagulation treatment guidelines remain uncertain for CHA2DS2-VASc score of 1. We conducted a systematic review and meta-analysis of the risk of ischemic stroke for patients with atrial fibrillation and CHA2DS2-VASc score of 0, 1, or 2 not treated with oral anticoagulation. METHODS:We searched MEDLINE, Embase, PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science from the start of the database up until April 15, 2015. We included studies that stratified the risk of ischemic stroke by CHA2DS2-VASc score for patients with nonvalvular atrial fibrillation. We estimated the summary annual rate of ischemic stroke using random effects meta-analyses and compared the estimated stroke rates with published net-benefit thresholds for initiating anticoagulants. RESULTS:1162 abstracts were retrieved, of which 10 met all inclusion criteria for the study. There was substantial heterogeneity among studies. The summary estimate for the annual risk of ischemic stroke was 1.61% (95% confidence interval 0%-3.23%) for CHA2DS2-VASc score of 1, meeting the theoretical threshold for using novel oral anticoagulants (0.9%), but below the threshold for warfarin (1.7%). The summary incident risk of ischemic stroke was 0.68% (95% confidence interval 0.12%-1.23%) for CHA2DS2-VASc score of 0 and 2.49% (95% confidence interval 1.16%-3.83%) for CHA2DS2-VASc score of 2. CONCLUSIONS:Our meta-analysis of ischemic stroke risk in atrial fibrillation patients suggests that those with CHA2DS2-VASc score of 1 may be considered for a novel oral anticoagulant, but because of high heterogeneity, the decision should be based on individual patient characteristics.

journal_name

Stroke

journal_title

Stroke

authors

Joundi RA,Cipriano LE,Sposato LA,Saposnik G,Stroke Outcomes Research Working Group.

doi

10.1161/STROKEAHA.115.012609

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

1364-7

issue

5

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.115.012609

journal_volume

47

pub_type

杂志文章,meta分析,评审

相关文献

STROKE文献大全
  • Deferoxamine attenuates white matter injury in a piglet intracerebral hemorrhage model.

    abstract:BACKGROUND AND PURPOSE:Deferoxamine reduces neuronal death in a piglet model of intracerebral hemorrhage (ICH). This study examined the effect of deferoxamine on perihematomal white matter edema in piglets. METHODS:ICH was induced by an injection of autologous blood into the right frontal lobe of piglets. In the first...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.003033

    authors: Xie Q,Gu Y,Hua Y,Liu W,Keep RF,Xi G

    更新日期:2014-01-01 00:00:00

  • Coffee consumption and risk of stroke in women.

    abstract:BACKGROUND AND PURPOSE:Coffee consumption has been inconsistently associated with stroke incidence and mortality in previous studies. We investigated the association between coffee consumption and stroke incidence in the Swedish Mammography Cohort. METHODS:We prospectively followed of 34,670 women without a history of...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.603787

    authors: Larsson SC,Virtamo J,Wolk A

    更新日期:2011-04-01 00:00:00

  • Photochemical stroke model: flunarizine prevents sensorimotor deficits after neocortical infarcts in rats.

    abstract::We produced unilateral photochemical infarcts in the hindlimb sensorimotor neocortex of 186 rats by intravenous injection of the fluorescein derivative rose bengal and focal illumination of the intact skull surface. Infarcted rats showed specific, long-lasting deficits in tactile and proprioceptive placing reactions o...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.20.10.1383

    authors: De Ryck M,Van Reempts J,Borgers M,Wauquier A,Janssen PA

    更新日期:1989-10-01 00:00:00

  • Lifestyle factors and risk of cerebral infarction.

    abstract:BACKGROUND AND PURPOSE:We evaluated the impact of lifestyle factors on the risk of ischemic stroke. METHODS:We used a nested case-control design. The cases comprised 163 persons (median age 69 years) admitted to a stroke unit and diagnosed with acute cerebral infarction. All cases had earlier participated in the North...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.23.6.829

    authors: Ellekjaer EF,Wyller TB,Sverre JM,Holmen J

    更新日期:1992-06-01 00:00:00

  • Fugl-Meyer assessment of sensorimotor function after stroke: standardized training procedure for clinical practice and clinical trials.

    abstract:BACKGROUND AND PURPOSE:Outcome measurement fidelity within and between sites of multi-site, randomized, clinical trials is an essential element to meaningful trial outcomes. As important are the methods developed for randomized, clinical trials that can have practical utility for clinical practice. A standardized measu...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/STROKEAHA.110.592766

    authors: Sullivan KJ,Tilson JK,Cen SY,Rose DK,Hershberg J,Correa A,Gallichio J,McLeod M,Moore C,Wu SS,Duncan PW

    更新日期:2011-02-01 00:00:00

  • Body weight after stroke: lessons from the obesity paradox.

    abstract:BACKGROUND AND PURPOSE:Outcome after acute stroke is determined to a large extent by poststroke complications. Nutritional status and metabolic balance may substantially contribute to outcome after stroke. Key mechanisms of stroke pathophysiology can induce systemic catabolic imbalance with impaired metabolic efficienc...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.111.619163

    authors: Scherbakov N,Dirnagl U,Doehner W

    更新日期:2011-12-01 00:00:00

  • Volume-regulated anion channels are the predominant contributors to release of excitatory amino acids in the ischemic cortical penumbra.

    abstract:BACKGROUND AND PURPOSE:Release of excitatory amino acids (EAA) is considered a cause of neuronal damage in ischemia. We investigated the sources and mechanisms of EAA release using microdialysis in regions of incomplete ischemia where perfusion was reduced by 50% to 80%, by applying inhibitors of volume-regulated anion...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000124127.57946.a1

    authors: Feustel PJ,Jin Y,Kimelberg HK

    更新日期:2004-05-01 00:00:00

  • Multimodal MRI in cerebral small vessel disease: its relationship with cognition and sensitivity to change over time.

    abstract:BACKGROUND AND PURPOSE:Cerebral small vessel disease is the most common cause of vascular dementia. Interest in using MRI parameters as surrogate markers of disease to assess therapies is increasing. In patients with symptomatic sporadic small vessel disease, we determined which MRI parameters best correlated with cogn...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.507475

    authors: Nitkunan A,Barrick TR,Charlton RA,Clark CA,Markus HS

    更新日期:2008-07-01 00:00:00

  • Corpus callosum and experimental stroke: studies in callosotomized rats and acallosal mice.

    abstract:BACKGROUND AND PURPOSE:Interhemispheric inhibition via the corpus callosum has been proposed as an exacerbating factor in outcome from stroke. METHODS:We measured infarct volume and behavioral outcome after middle cerebral artery occlusion in callosotomized rats and acallosal mice. RESULTS:Neither callosotomy in rats...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.111.613349

    authors: Jin K,Xie L,Sun F,Mao X,Greenberg DA

    更新日期:2011-09-01 00:00:00

  • Incidence and causes of strokes associated with pregnancy and puerperium. A study in public hospitals of Ile de France. Stroke in Pregnancy Study Group.

    abstract:BACKGROUND AND PURPOSE:The incidence, causes, and prognosis of nonhemorrhagic strokes and intraparenchymal hemorrhages occurring in association with pregnancy or puerperium are poorly understood. METHODS:We carried out a retrospective (1989 through 1991) and prospective (1992) study in 63 public maternities (348,295 d...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.6.930

    authors: Sharshar T,Lamy C,Mas JL

    更新日期:1995-06-01 00:00:00

  • Prevalence and causes of early-onset dementia in Japan: a population-based study.

    abstract:BACKGROUND AND PURPOSE:Few studies are available that have addressed the prevalence of early-onset dementia (EOD), including early-onset Alzheimer disease and other forms of dementia in Japan. METHODS:A 2-step postal survey was sent to all of the 2475 institutions providing medical or care services for individuals wit...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.108.542308

    authors: Ikejima C,Yasuno F,Mizukami K,Sasaki M,Tanimukai S,Asada T

    更新日期:2009-08-01 00:00:00

  • Role of potassium channels in relaxations of canine middle cerebral arteries induced by nitric oxide donors.

    abstract:BACKGROUND AND PURPOSE:The mechanisms underlying smooth muscle relaxations of cerebral arteries in response to nitric oxide (NO) and cyclic GMP (cGMP) are still not completely understood. The present study was designed to determine the role of potassium channels in the relaxations to NO donors 3-morpholinosydnonimine (...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.28.6.1264

    authors: Onoue H,Katusic ZS

    更新日期:1997-06-01 00:00:00

  • Combined Multimodal Computed Tomography Score Correlates With Futile Recanalization After Thrombectomy in Patients With Acute Stroke.

    abstract:BACKGROUND AND PURPOSE:Futile recanalization after acute ischemic stroke occurs in almost half of the patients despite optimal angiographic results. Multimodal neuroimaging may help to improve patient's selection but is still dismissed by many interventionalists. Our aim was to evaluate the accuracy of each parameter o...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.114.008598

    authors: Espinosa de Rueda M,Parrilla G,Manzano-Fernández S,García-Villalba B,Zamarro J,Hernández-Fernández F,Sánchez-Vizcaino C,Carreón E,Morales A,Moreno A

    更新日期:2015-09-01 00:00:00

  • Gene therapy and endovascular treatment of intracranial aneurysms.

    abstract:BACKGROUND:Endovascular treatment of intracranial aneurysms is safe and effective but too often is followed by recurrences. Gene therapy may improve healing after embolization, and endovascular approaches may offer future in situ delivery systems designed to prevent aneurysm rupture. SUMMARY OF REVIEW:Advances in coil...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/01.STR.0000117577.94345.CC

    authors: Ribourtout E,Raymond J

    更新日期:2004-03-01 00:00:00

  • Magnetic Resonance Imaging Findings Related to Stroke Risk in Japanese Patients With Fabry Disease.

    abstract::Background and Purpose- Stroke is the most frequent severe clinical event in patients with Fabry disease. We aimed to evaluate the cerebral magnetic resonance imaging findings of patients with Fabry disease and assess their association with future stroke risk after enzyme replacement therapy (ERT) induction. Methods- ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.119.025528

    authors: Yagita Y,Sakai N,Miwa K,Ohara N,Tanaka M,Sakaguchi M,Kitagawa K,Mochizuki H

    更新日期:2019-09-01 00:00:00

  • Acute and long-term increase in fracture risk after hospitalization for stroke.

    abstract:BACKGROUND AND PURPOSE:The aims of this study were to determine the magnitude of the increase in fracture risk after hospitalization for stroke, and in particular to determine the time course of this risk. METHODS:The records of the Swedish register of patients admitted during 1987-1996 were examined to identify all p...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.32.3.702

    authors: Kanis J,Oden A,Johnell O

    更新日期:2001-03-01 00:00:00

  • Risk of stroke with mitral valve prolapse in population-based cohort study.

    abstract:BACKGROUND AND PURPOSE:The purpose of this study was to clarify whether mitral valve prolapse increases the subsequent risk of stroke. METHODS:A historical cohort study was conducted on 1079 residents of Olmsted County, Minnesota, who had an initial echocardiographic diagnosis of mitral valve prolapse between 1975 and...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.1.7

    authors: Orencia AJ,Petty GW,Khandheria BK,Annegers JF,Ballard DJ,Sicks JD,O'Fallon WM,Whisnant JP

    更新日期:1995-01-01 00:00:00

  • Neuroprotective effects of leptin against ischemic injury induced by oxygen-glucose deprivation and transient cerebral ischemia.

    abstract:BACKGROUND AND PURPOSE:Leptin is the major adipose hormone that regulates body weight and energy expenditure by activating leptin receptors in the hypothalamus. Leptin receptors are also present in other cell types, and a potent antiapoptotic effect for leptin has recently been reported. We investigated whether leptin ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.482786

    authors: Zhang F,Wang S,Signore AP,Chen J

    更新日期:2007-08-01 00:00:00

  • Desirable Low-Density Lipoprotein Cholesterol Levels for Preventing Stroke Recurrence: A Post Hoc Analysis of the J-STARS Study (Japan Statin Treatment Against Recurrent Stroke).

    abstract:BACKGROUND AND PURPOSE:To define desirable target low-density lipoprotein (LDL) cholesterol levels for the prevention of stroke recurrence, a post hoc analysis was performed in the J-STARS study (Japan Statin Treatment Against Recurrent Stroke). METHODS:Subjects (n=1578) were divided into groups based on mean value of...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.117.018870

    authors: Hosomi N,Kitagawa K,Nagai Y,Nakagawa Y,Aoki S,Nezu T,Kagimura T,Maruyama H,Origasa H,Minematsu K,Uchiyama S,Matsumoto M,J-STARS Collaborators.

    更新日期:2018-04-01 00:00:00

  • Alteration of intracellular metabolite diffusion in rat brain in vivo during ischemia and reperfusion.

    abstract:BACKGROUND AND PURPOSE:Diffusion-weighted MRI can demonstrate decreases of the apparent diffusion coefficient (ADC) of brain tissue water shortly after the onset of ischemia. To further elucidate underlying mechanisms, this study extended diffusion assessment to intracellular metabolites in rat brain in vivo before, du...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.10.1930

    authors: Wick M,Nagatomo Y,Prielmeier F,Frahm J

    更新日期:1995-10-01 00:00:00

  • Stent placement in acute cerebral artery occlusion: use of a self-expandable intracranial stent for acute stroke treatment.

    abstract:BACKGROUND AND PURPOSE:Stent placement has been applied in small case series as a rescue therapy in combination with different thrombolytic agents, percutaneous balloon angioplasty (PTA), and mechanical thromboembolectomy (MT) in acute stroke treatment. These studies report a considerable mortality and a high rate of i...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.108.533810

    authors: Brekenfeld C,Schroth G,Mattle HP,Do DD,Remonda L,Mordasini P,Arnold M,Nedeltchev K,Meier N,Gralla J

    更新日期:2009-03-01 00:00:00

  • Impact of anatomic features in the endovascular embolization of 181 anterior communicating artery aneurysms.

    abstract:BACKGROUND AND PURPOSE:We analyzed the impact of detailed anatomic characteristics on the results of endovascular coil embolization for anterior communicating artery (AcoA) aneurysms and developed a predictive model estimating the probability of successful endovascular treatment. METHODS:One hundred eighty-one AcoA an...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.505222

    authors: Gonzalez N,Sedrak M,Martin N,Vinuela F

    更新日期:2008-10-01 00:00:00

  • Inclusion of stroke in cardiovascular risk prediction instruments: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

    abstract:BACKGROUND AND PURPOSE:Current US guideline statements regarding primary and secondary cardiovascular risk prediction and prevention use absolute risk estimates to identify patients who are at high risk for vascular disease events and who may benefit from specific preventive interventions. These guidelines do not expli...

    journal_title:Stroke

    pub_type: 杂志文章,实务指引

    doi:10.1161/STR.0b013e31825bcdac

    authors: Lackland DT,Elkind MS,D'Agostino R Sr,Dhamoon MS,Goff DC Jr,Higashida RT,McClure LA,Mitchell PH,Sacco RL,Sila CA,Smith SC Jr,Tanne D,Tirschwell DL,Touzé E,Wechsler LR,American Heart Association Stroke Council.,Council on

    更新日期:2012-07-01 00:00:00

  • Ischemic stroke during sleep: its association with worse early functional outcome.

    abstract:BACKGROUND AND PURPOSE:Approximately one fourth of stroke occur during sleep. Despite the clinical and radiological similarities between wake-up stroke (WUS) and non-WUS, the functional outcomes of WUS are largely unknown. METHODS:This retrospective analysis reviewed 2289 consecutive patients with acute ischemic strok...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.602243

    authors: Kim BJ,Lee SH,Shin CW,Ryu WS,Kim CK,Yoon BW

    更新日期:2011-07-01 00:00:00

  • Stroke and Embolic Events in Hypertrophic Cardiomyopathy: Risk Stratification in Patients Without Atrial Fibrillation.

    abstract:BACKGROUND AND PURPOSE:Stroke and systemic embolic events are known to occur as complications of hypertrophic cardiomyopathy (HCM), and these complications are more common in patients with accompanying atrial fibrillation (AF). The diagnosis of AF is sometimes difficult, however, and it is possible that subclinical asy...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.115.012130

    authors: Haruki S,Minami Y,Hagiwara N

    更新日期:2016-04-01 00:00:00

  • Heritability of carotid artery distensibility in Hispanics: the Northern Manhattan Family Study.

    abstract:BACKGROUND AND PURPOSE:Reduced arterial distensibility has been introduced as a novel risk factor for atherosclerosis. The importance of the genetic contribution to variation in distensibility is largely unknown. The purpose of this study was to estimate heritability of carotid distensibility. METHODS:The ongoing Nort...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000185926.05011.72

    authors: Juo SH,Rundek T,Lin HF,Cheng R,Lan MY,Huang JS,Boden-Albala B,Sacco RL

    更新日期:2005-11-01 00:00:00

  • Cerebral infarction immediately after ingestion of hydrogen peroxide solution.

    abstract:BACKGROUND:We report the clinical and neuroimaging findings of a patient who sustained multiple cerebral infarcts after the ingestion of concentrated hydrogen peroxide solution sold as a "health food" product. CASE DESCRIPTION:An 84-year-old man sustained focal neurological deficits immediately after ingesting 30 mL o...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.25.5.1065

    authors: Sherman SJ,Boyer LV,Sibley WA

    更新日期:1994-05-01 00:00:00

  • Cerebral vasomotor reactivity in normotensive and spontaneously hypertensive rats.

    abstract::Intravenously injected metaraminol induced a larger blood pressure increase in spontaneously hypertensive rats (SHR) than in normotensive controls (NR) when the pressure was raised from the same starting level. Cerebral blood flow (CBF) response in NR was either perfect autoregulation, partial autoregulation or "break...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.10.5.572

    authors: Johansson BB,Nilsson B

    更新日期:1979-09-01 00:00:00

  • Disparities in Antihypertensive Prescribing After Stroke: Linked Data From the Australian Stroke Clinical Registry.

    abstract::Background and Purpose- Despite evidence to support the prescription of antihypertensive medications before hospital discharge to promote medication adherence and prevent recurrent events, many patients with stroke miss out on these medications at discharge. We aimed to examine patient, clinical, and system-level diff...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.119.026823

    authors: Dalli LL,Kim J,Thrift AG,Andrew NE,Lannin NA,Anderson CS,Grimley R,Katzenellenbogen JM,Boyd J,Lindley RI,Pollack M,Jude M,Durairaj R,Shah D,Cadilhac DA,Kilkenny MF

    更新日期:2019-12-01 00:00:00

  • Cerebral oxygen metabolism and neuronal integrity in patients with impaired vasoreactivity attributable to occlusive carotid artery disease.

    abstract:BACKGROUND AND PURPOSE:It is still unclear that impaired cerebrovascular reactivity (CVR) to acetazolamide is comparable to elevated oxygen extraction fraction (OEF) on positron emission tomography (PET) in patients with occlusive carotid diseases. Therefore, in this study, the authors aimed to clarify whether OEF is e...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000198878.66000.4e

    authors: Kuroda S,Shiga T,Houkin K,Ishikawa T,Katoh C,Tamaki N,Iwasaki Y

    更新日期:2006-02-01 00:00:00