Pedro Morillas1, Vicente Pallarés2, Lorenzo Fácila3, Jose Luis Llisterri4, María Eugenia Sebastián5, Manuel Gómez6, Elena Castilla6, Raquel Camarasa6, Miriam Sandin6, Antonio García-Honrubia6. 1. Servicio de Cardiología, Hospital General Universitario de Elche, Elche, Alicante, Spain. Electronic address: pedromorillas68@gmail.com. 2. Unidad de Vigilancia de la Salud, Unión de Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Spain. 3. Servicio de Cardiología, Hospital General de Valencia, Valencia, Spain. 4. Centro de Salud Joaquín Benlloch, Valencia, Spain. 5. Servicio de Anestesia y Reanimación, Hospital General Universitario de Elche, Elche, Alicante, Spain. 6. Servicio de Cardiología, Hospital General Universitario de Elche, Elche, Alicante, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: The CHADS2 score is a proven, essential tool for estimating cardioembolic risk (mainly stroke) in patients with nonvalvular atrial fibrillation, with the purpose of determining the indication for anticoagulant therapy. In this study we analyzed the use of CHADS2 in hypertensive patients without known atrial fibrillation in a Mediterranean population. METHODS: The study included 887 hypertensive patients aged 65 years or older without atrial fibrillation or anticoagulant therapy, who attended a medical consultation. Data on the patients' main risk factors, cardiovascular history, and medication were collected, basic laboratory analyses and electrocardiography were performed, and the CHADS2 score (heart failure, hypertension, age ≥ 75 years, diabetes mellitus, and previous stroke or transient ischemic attack) was calculated. A clinical follow-up was carried out, recording hospital admissions for a stroke or transient ischemic attack. The median duration of follow-up was 804 days. RESULTS: Mean age was 72.5 (SD,5.7) years, 46.6% were men, 27.8% had diabetes, and 8.6% were smokers. During follow-up, 40 patients were hospitalized for a stroke or transient ischemic attack (4.5%). The event-free survival analysis showed significant differences according to the CHADS2 score (log rank test, P < .001). On multivariate analysis, smoking and CHADS2 ≥3 were independent predictors of stroke or transient ischemic attack. CONCLUSIONS: The CHADS2 may be useful for estimating the risk of stroke or transient ischemic attack in hypertensive patients without known atrial fibrillation.
INTRODUCTION AND OBJECTIVES: The CHADS2 score is a proven, essential tool for estimating cardioembolic risk (mainly stroke) in patients with nonvalvular atrial fibrillation, with the purpose of determining the indication for anticoagulant therapy. In this study we analyzed the use of CHADS2 in hypertensivepatients without known atrial fibrillation in a Mediterranean population. METHODS: The study included 887 hypertensivepatients aged 65 years or older without atrial fibrillation or anticoagulant therapy, who attended a medical consultation. Data on the patients' main risk factors, cardiovascular history, and medication were collected, basic laboratory analyses and electrocardiography were performed, and the CHADS2 score (heart failure, hypertension, age ≥ 75 years, diabetes mellitus, and previous stroke or transient ischemic attack) was calculated. A clinical follow-up was carried out, recording hospital admissions for a stroke or transient ischemic attack. The median duration of follow-up was 804 days. RESULTS: Mean age was 72.5 (SD,5.7) years, 46.6% were men, 27.8% had diabetes, and 8.6% were smokers. During follow-up, 40 patients were hospitalized for a stroke or transient ischemic attack (4.5%). The event-free survival analysis showed significant differences according to the CHADS2 score (log rank test, P < .001). On multivariate analysis, smoking and CHADS2 ≥3 were independent predictors of stroke or transient ischemic attack. CONCLUSIONS: The CHADS2 may be useful for estimating the risk of stroke or transient ischemic attack in hypertensivepatients without known atrial fibrillation.
Authors: Piotr Sobieraj; Jacek Lewandowski; Maciej Siński; Bartosz Symonides; Zbigniew Gaciong Journal: J Am Heart Assoc Date: 2019-02-19 Impact factor: 5.501
Authors: Eulalia Muria-Subirats; Josep Lluis Clua-Espuny; Juan Ballesta-Ors; Blanca Lorman-Carbo; Iñigo Lechuga-Duran; Jose Fernández-Saez; Roger Pla-Farnos Journal: Int J Environ Res Public Health Date: 2020-05-16 Impact factor: 4.614