CHA2DS2-VASc score and heart rate predict ischemic stroke outcomes in patients with atrial fibrillation

Chih Shan Huang, Chin I. Chen, Ya Ting Liu, Jen Hung Huang, Yi Jen Chen

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Purpose: To evaluate the factors determining the severity and outcome of ischemic stroke in patients with atrial fibrillation (AF). Methods: Our study examined 210 patients with AF and acute ischemic stroke to investigate the relative risks of age, gender, comorbidities, CHADS2 and CHA 2DS2-VASc scores, warfarin use, heart rate, and blood pressure on stroke severity, hospitalization duration, and mortality rate. Results: Patients with poor outcomes [n = 109, National Institutes of Health Stroke Scale (NIHSS) scores of ≥8] had elevated CHA2DS2-VASc scores [5, interquartile range (IQR) 3-6 versus 4, IQR 2.5-5, p = 0.005] and were older with a female predominance, less prior warfarin use, and a higher heart rate (93 ± 24 versus 84 ± 20 beats/min, p = 0.004) in the emergency department, with a longer duration of hospitalization (24 ± 23 versus 11 ± 12 days, p <0.001) and a higher mortality rate (11.0% versus 0.0%, p = 0.002) than those with better outcomes (n = 101, low NIHSS scores of ≤ 7). Patients who died (n = 12) were older and had a higher NIHSS, CHADS2 (3.5, IQR 2-4.75 versus 2, IQR 1-4, p = 0.040), or CHA2DS2-VASc (5.5, IQR 4-6 versus 4, IQR 3-5, p = 0.046) scores than patients who survived. The multivariate analysis showed that female gender, no prior warfarin use, and heart rate were independent predictors of stroke severity. Conclusions: Our results showed that CHADS2 and CHA2DS2-VASc scores, and heart rate were useful parameters for predicting outcomes in AF patients with stroke.

Original languageEnglish
Pages (from-to)16-21
Number of pages6
JournalActa Cardiologica Sinica
Issue number1
Publication statusPublished - Jan 2014


  • Atrial fibrillation
  • Heart rate
  • Ischemic stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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