The relationship between clinical and demographic data and CHA2DS2-VASc score of patients with stroke of unknownsource who had PAF on 24-hour rhythm holter ECG

• Main Authors: Aygül Tantik Pak, Zahide Mail Gürkan, Yıldızhan Şengül
• Format: Article
• Language: English
• Published: Turkish Society of Cerebrovascular Diseases 2019-12-01
• Series: Türk Beyin Damar Hastalıkları Dergisi
• Subjects: atrial fibrillation; cha2ds2-vasc score; stroke; paroxysmal atrial fibrillation; stroke of unknownsource; rhythm holter
• Online Access: https://www.journalagent.com/tbdhd/pdfs/TBDHD-46338-RESEARCH_ARTICLE-TANTIK_PAK.pdf

INTRODUCTION: The cause of approximately 25% of ischemic strokes is unknown. In many studies, paroxysmal atrial fibrillation (PAF) was found in 11-30% of stroke of unknownsource. Compared to the general population, the risk of stroke is twice as high in patients with PAF. CHA2DS2VAS score is used to determine the risk of stroke in patients with AF. In this study, we aimed to investigate the relationship between clinical and demographic data and CHA2DS2VAS score of patients with stroke of unknownsource who had PAF on 24-hour rhythm holter electrocardiography (ECG). METHODS: Patients who were diagnosed with ischemic stroke in our clinic between 2017-2019 and whose etiology could not be determined and who had PAF on 24-hour rhythm holter ECG were included in the study. Demographic data were recorded, CHA2DS2VAS score, NIHSS (National Institute of Healt Stroke Scale Scores), ASPECT (The Alberta Stroke Program Early CT Score) values, mRS (modified Rankin Scale) were calculated. The relationship between demographic, clinical and imaging data and CHA2DS2VAS score was compared. RESULTS: The mean age of the 48 patients included in our study was 67.10 ± 12.05. 52.1% (n: 25) of the patients were female and 48.9% (n: 23) were male. The most frequent complaints of the patients were weakness of the arm and leg, impaired speech, and impaired consciousness. Congestive heart failure (CHF) in 6.3% (n: 3), diabetes mellitus (DM) in 29.2% (n: 14), hypertension (HT) in 75% (n: 36), 27.1% (n: 13) had vascular disease. The effect of age on the CHA2DS2VAS score was most prominent (β: 0.676, p <0.01), followed by a high rate of effect on DM and CHF. DISCUSSION AND CONCLUSION: In our study, age was the most effective factor on CHA2DS2VAS score. This shows that the rate of PAF detection on 24-hour rhythm holter ECG was increases with age.