%0 Journal Article
%T The determinants of stroke phenotypes were different from the predictors (CHADS2 and CHA2DS2-VASc) of stroke in patients with atrial fibrillation: a comprehensive approach
%A Semi Oh
%A Suk Kim
%A Soo-Kyoung Ryu
%A Gyeong-Moon Kim
%A Chin Chung
%A Kwang Lee
%A Oh Bang
%J BMC Neurology
%D 2011
%I BioMed Central
%R 10.1186/1471-2377-11-107
%X We analyzed data pertaining to consecutive AF patients admitted over a 6-year period with acute MCA territory infarcts. We divided the patients according to DWI (diffusion-weighted imaging) lesion volumes and patterns, and the relationship between stroke predictors (the CHADS2 and CHA2DS2-VASc score), systemic, and local factors and each stroke phenotype were then evaluated.The stroke phenotypes varied among 231 patients (admission INR median 1.06, interquartile range (IQR) 1.00-1.14). Specifically, (1) the DWI lesion volumes ranged from 0.04-338.62 ml (median 11.86 ml; IQR, 3.07-44.20 ml) and (2) 46 patients had a territorial infarct pattern, 118 had a lobar/deep pattern and 67 had a small scattered pattern. Multivariate testing revealed that the CHADS2 and CHA2DS2-VASc score were not related to either stroke phenotype. Additionally, the prior use of antiplatelet agents was not related to the stroke phenotypes. Congestive heart failure and diastolic dysfunction were not associated with stroke phenotypes.The results of this study indicated that the determinants of stroke phenotypes were different from the predictors (i.e., CHADS2 and CHA2DS2-VASc score) of stroke in patients with AF.Atrial fibrillation (AF) affects 3% to 5% of the population older than 65 years of age [1] and is a leading cause of fatal ischemic stroke [2,3]. Stroke in patients with AF is generally more severe and the outcome is markedly poorer than in patients with sinus rhythm [4]. Adjusted-dose warfarin is highly effective (~60% reduction), and aspirin is modestly effective (~20% reduction) for the prevention of stroke in AF [5,6]. Moreover, international normalized ratio (INR) levels at the time of stroke were recently reported to be associated with infarct volumes [7].However, the factors affecting stroke phenotypes are unknown among AF patients. Several studies have suggested that infarct patterns are better delineated by DWI than other imaging modalities, are correlated with the underlying st
%U http://www.biomedcentral.com/1471-2377/11/107