Association between CHADS2, CHA2 DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients

Hyung Jun Kim; Moo Seok Park; Joonsang Yoo; Young Dae Kim; Hyungjong Park; Byung Moon Kim; Oh Young Bang; Hyeon Chang Kim; Euna Han; Dong Joon Kim; Joonnyung Heo; Jin Kyo Choi; Kyung Yul Lee; Hye Sun Lee; Dong Hoon Shin; Hye Yeon Choi; Sung Il Sohn; Jeong Ho Hong; Jong Yun Lee; Jang Hyun Baek; Gyu Sik Kim; Woo Keun Seo; Jong Won Chung; Seo Hyun Kim; Sang Won Han; Joong Hyun Park; Jinkwon Kim; Yo Han Jung; Han Jin Cho; Seong Hwan Ahn; Sung Ik Lee; Kwon Duk Seo; Yoonkyung Chang; Tae Jin Song; Hyo Suk Nam

doi:10.3390/jcm11010274

Association between CHADS₂, CHA₂ DS₂-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients

Hyung Jun Kim, Moo Seok Park, Joonsang Yoo, Young Dae Kim, Hyungjong Park, Byung Moon Kim, Oh Young Bang, Hyeon Chang Kim, Euna Han, Dong Joon Kim, Joonnyung Heo, Jin Kyo Choi, Kyung Yul Lee, Hye Sun Lee, Dong Hoon Shin, Hye Yeon Choi, Sung Il Sohn, Jeong Ho Hong, Jong Yun Lee, Jang Hyun BaekGyu Sik Kim, Woo Keun Seo, Jong Won Chung, Seo Hyun Kim, Sang Won Han, Joong Hyun Park, Jinkwon Kim, Yo Han Jung, Han Jin Cho, Seong Hwan Ahn, Sung Ik Lee, Kwon Duk Seo, Yoonkyung Chang, Tae Jin Song, Hyo Suk Nam

Department of Neurology

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Background: The CHADS₂, CHA₂ DS₂-VASc, ATRIA, and Essen scores have been developed for predicting vascular outcomes in stroke patients. We investigated the association between these stroke risk scores and unsuccessful recanalization after endovascular thrombectomy (EVT). Methods: From the nationwide multicenter registry (Selection Criteria in Endovascular Thrombectomy and Thrombolytic therapy (SECRET)) (Clinicaltrials.gov NCT02964052), we consecutively included 501 patients who underwent EVT. We identified pre-admission stroke risk scores in each included patient. Results: Among 501 patients who underwent EVT, 410 (81.8%) patients achieved successful recanalization (mTICI ≥ 2b). Adjusting for body mass index and p < 0.1 in univariable analysis revealed the association between all stroke risk scores and unsuccessful recanalization (CHADS₂ score: odds ratio (OR) 1.551, 95% confidence interval (CI) 1.198–2.009, p = 0.001; CHA₂ DS₂ VASc score: OR 1.269, 95% CI 1.080–1.492, p = 0.004; ATRIA score: OR 1.089, 95% CI 1.011–1.174, p = 0.024; and Essen score: OR 1.469, 95% CI 1.167–1.849, p = 0.001). The CHADS₂ score had the highest AUC value and differed significantly only from the Essen score (AUC of CHADS₂ score; 0.618, 95% CI 0.554–0.681). Conclusion: All stroke risk scores were associated with unsuccessful recanalization after EVT. Our study suggests that these stroke risk scores could be used to predict recanalization in stroke patients undergoing EVT.

Original language	English
Article number	274
Journal	Journal of Clinical Medicine
Volume	11
Issue number	1
DOIs	https://doi.org/10.3390/jcm11010274
State	Published - 1 Jan 2022

Bibliographical note

Funding Information:
Funding: This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2021R1F1A1048113). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

Ischemic stroke
Recanalization
Stroke risk score
Thrombectomy

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10.3390/jcm11010274

Cite this

Kim, H. J., Park, M. S., Yoo, J., Kim, Y. D., Park, H., Kim, B. M., Bang, O. Y., Kim, H. C., Han, E., Kim, D. J., Heo, J., Choi, J. K., Lee, K. Y., Lee, H. S., Shin, D. H., Choi, H. Y., Sohn, S. I., Hong, J. H., Lee, J. Y., ... Nam, H. S. (2022). Association between CHADS₂, CHA₂ DS₂-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients. Journal of Clinical Medicine, 11(1), Article 274. https://doi.org/10.3390/jcm11010274

@article{91c25faea5dc409ca9db6afe3b3713ab,

title = "Association between CHADS2, CHA2 DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients",

abstract = "Background: The CHADS2, CHA2 DS2-VASc, ATRIA, and Essen scores have been developed for predicting vascular outcomes in stroke patients. We investigated the association between these stroke risk scores and unsuccessful recanalization after endovascular thrombectomy (EVT). Methods: From the nationwide multicenter registry (Selection Criteria in Endovascular Thrombectomy and Thrombolytic therapy (SECRET)) (Clinicaltrials.gov NCT02964052), we consecutively included 501 patients who underwent EVT. We identified pre-admission stroke risk scores in each included patient. Results: Among 501 patients who underwent EVT, 410 (81.8%) patients achieved successful recanalization (mTICI ≥ 2b). Adjusting for body mass index and p < 0.1 in univariable analysis revealed the association between all stroke risk scores and unsuccessful recanalization (CHADS2 score: odds ratio (OR) 1.551, 95% confidence interval (CI) 1.198–2.009, p = 0.001; CHA2 DS2 VASc score: OR 1.269, 95% CI 1.080–1.492, p = 0.004; ATRIA score: OR 1.089, 95% CI 1.011–1.174, p = 0.024; and Essen score: OR 1.469, 95% CI 1.167–1.849, p = 0.001). The CHADS2 score had the highest AUC value and differed significantly only from the Essen score (AUC of CHADS2 score; 0.618, 95% CI 0.554–0.681). Conclusion: All stroke risk scores were associated with unsuccessful recanalization after EVT. Our study suggests that these stroke risk scores could be used to predict recanalization in stroke patients undergoing EVT.",

keywords = "Ischemic stroke, Recanalization, Stroke risk score, Thrombectomy",

author = "Kim, {Hyung Jun} and Park, {Moo Seok} and Joonsang Yoo and Kim, {Young Dae} and Hyungjong Park and Kim, {Byung Moon} and Bang, {Oh Young} and Kim, {Hyeon Chang} and Euna Han and Kim, {Dong Joon} and Joonnyung Heo and Choi, {Jin Kyo} and Lee, {Kyung Yul} and Lee, {Hye Sun} and Shin, {Dong Hoon} and Choi, {Hye Yeon} and Sohn, {Sung Il} and Hong, {Jeong Ho} and Lee, {Jong Yun} and Baek, {Jang Hyun} and Kim, {Gyu Sik} and Seo, {Woo Keun} and Chung, {Jong Won} and Kim, {Seo Hyun} and Han, {Sang Won} and Park, {Joong Hyun} and Jinkwon Kim and Jung, {Yo Han} and Cho, {Han Jin} and Ahn, {Seong Hwan} and Lee, {Sung Ik} and Seo, {Kwon Duk} and Yoonkyung Chang and Song, {Tae Jin} and Nam, {Hyo Suk}",

note = "Funding Information: Funding: This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2021R1F1A1048113). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2022",

month = jan,

day = "1",

doi = "10.3390/jcm11010274",

language = "English",

volume = "11",

journal = "Journal of Clinical Medicine",

issn = "2077-0383",

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Kim, HJ, Park, MS, Yoo, J, Kim, YD, Park, H, Kim, BM, Bang, OY, Kim, HC, Han, E, Kim, DJ, Heo, J, Choi, JK, Lee, KY, Lee, HS, Shin, DH, Choi, HY, Sohn, SI, Hong, JH, Lee, JY, Baek, JH, Kim, GS, Seo, WK, Chung, JW, Kim, SH, Han, SW, Park, JH, Kim, J, Jung, YH, Cho, HJ, Ahn, SH, Lee, SI, Seo, KD, Chang, Y , Song, TJ & Nam, HS 2022, 'Association between CHADS₂, CHA₂ DS₂-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients', Journal of Clinical Medicine, vol. 11, no. 1, 274. https://doi.org/10.3390/jcm11010274

TY - JOUR

T1 - Association between CHADS2, CHA2 DS2-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients

AU - Kim, Hyung Jun

AU - Park, Moo Seok

AU - Yoo, Joonsang

AU - Kim, Young Dae

AU - Park, Hyungjong

AU - Kim, Byung Moon

AU - Bang, Oh Young

AU - Kim, Hyeon Chang

AU - Han, Euna

AU - Kim, Dong Joon

AU - Heo, Joonnyung

AU - Choi, Jin Kyo

AU - Lee, Kyung Yul

AU - Lee, Hye Sun

AU - Shin, Dong Hoon

AU - Choi, Hye Yeon

AU - Sohn, Sung Il

AU - Hong, Jeong Ho

AU - Lee, Jong Yun

AU - Baek, Jang Hyun

AU - Kim, Gyu Sik

AU - Seo, Woo Keun

AU - Chung, Jong Won

AU - Kim, Seo Hyun

AU - Han, Sang Won

AU - Park, Joong Hyun

AU - Kim, Jinkwon

AU - Jung, Yo Han

AU - Cho, Han Jin

AU - Ahn, Seong Hwan

AU - Lee, Sung Ik

AU - Seo, Kwon Duk

AU - Chang, Yoonkyung

AU - Song, Tae Jin

AU - Nam, Hyo Suk

N1 - Funding Information: Funding: This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2021R1F1A1048113). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2022/1/1

Y1 - 2022/1/1

N2 - Background: The CHADS2, CHA2 DS2-VASc, ATRIA, and Essen scores have been developed for predicting vascular outcomes in stroke patients. We investigated the association between these stroke risk scores and unsuccessful recanalization after endovascular thrombectomy (EVT). Methods: From the nationwide multicenter registry (Selection Criteria in Endovascular Thrombectomy and Thrombolytic therapy (SECRET)) (Clinicaltrials.gov NCT02964052), we consecutively included 501 patients who underwent EVT. We identified pre-admission stroke risk scores in each included patient. Results: Among 501 patients who underwent EVT, 410 (81.8%) patients achieved successful recanalization (mTICI ≥ 2b). Adjusting for body mass index and p < 0.1 in univariable analysis revealed the association between all stroke risk scores and unsuccessful recanalization (CHADS2 score: odds ratio (OR) 1.551, 95% confidence interval (CI) 1.198–2.009, p = 0.001; CHA2 DS2 VASc score: OR 1.269, 95% CI 1.080–1.492, p = 0.004; ATRIA score: OR 1.089, 95% CI 1.011–1.174, p = 0.024; and Essen score: OR 1.469, 95% CI 1.167–1.849, p = 0.001). The CHADS2 score had the highest AUC value and differed significantly only from the Essen score (AUC of CHADS2 score; 0.618, 95% CI 0.554–0.681). Conclusion: All stroke risk scores were associated with unsuccessful recanalization after EVT. Our study suggests that these stroke risk scores could be used to predict recanalization in stroke patients undergoing EVT.

AB - Background: The CHADS2, CHA2 DS2-VASc, ATRIA, and Essen scores have been developed for predicting vascular outcomes in stroke patients. We investigated the association between these stroke risk scores and unsuccessful recanalization after endovascular thrombectomy (EVT). Methods: From the nationwide multicenter registry (Selection Criteria in Endovascular Thrombectomy and Thrombolytic therapy (SECRET)) (Clinicaltrials.gov NCT02964052), we consecutively included 501 patients who underwent EVT. We identified pre-admission stroke risk scores in each included patient. Results: Among 501 patients who underwent EVT, 410 (81.8%) patients achieved successful recanalization (mTICI ≥ 2b). Adjusting for body mass index and p < 0.1 in univariable analysis revealed the association between all stroke risk scores and unsuccessful recanalization (CHADS2 score: odds ratio (OR) 1.551, 95% confidence interval (CI) 1.198–2.009, p = 0.001; CHA2 DS2 VASc score: OR 1.269, 95% CI 1.080–1.492, p = 0.004; ATRIA score: OR 1.089, 95% CI 1.011–1.174, p = 0.024; and Essen score: OR 1.469, 95% CI 1.167–1.849, p = 0.001). The CHADS2 score had the highest AUC value and differed significantly only from the Essen score (AUC of CHADS2 score; 0.618, 95% CI 0.554–0.681). Conclusion: All stroke risk scores were associated with unsuccessful recanalization after EVT. Our study suggests that these stroke risk scores could be used to predict recanalization in stroke patients undergoing EVT.

KW - Ischemic stroke

KW - Recanalization

KW - Stroke risk score

KW - Thrombectomy

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U2 - 10.3390/jcm11010274

DO - 10.3390/jcm11010274

M3 - Article

AN - SCOPUS:85122204429

SN - 2077-0383

VL - 11

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 1

M1 - 274

ER -