Stroke Risk Stratification by CHADS2 Score in Patients Undergoing PCI without Atrial Fibrillation: The CREDO-Kyoto Registry Cohort 3

From the CREDO-Kyoto Registry Cohort 3, an increased CHADS₂ score was associated with an increased risk and severity of ischemic stroke in patients undergoing PCI, regardless of whether they had atrial fibrillation or not, reported Dr. Yuki Obayashi and colleagues from the Kyoto University Graduate School of Medicine reported in the October 15 issue of The American Journal of Cardiology.

Dr. Obayashi and colleagues included 11,516 patients with coronary artery disease undergoing PCI who were enrolled in the CREDO-Kyoto Registry Cohort 3. They then divided the patients into two groups for 721 patients with atrial fibrillation and 10,795 patients without it. The association between CHADS₂ score and long-term risk of ischemic stroke and its severity was evaluated.

As CHADS₂ scores increased from 0 or 1 to 6, the 5-year incidence of ischemic stroke increased progressively from 2.1% to 17.1% in patients without atrial fibrillation and from 4.2% to 40.7% in patients with atrial fibrillation. The 5-year incidence of ischemic stroke in non-atrial fibrillation patients with a CHADS₂ score of 2 was numerically similar to that in atrial fibrillation patients with a CHADS₂ score of 1 (3.4% vs. 3.7%).

There was no significant difference in mRS scores among the 423 patients who developed ischemic stroke according to whether they had atrial fibrillation or not (p trend=0.12). Elevated CHADS₂ scores were significantly associated with higher mRS scores in both atrial fibrillation and non-atrial fibrillation patients (p trend=0.03 and p trend<0.001, respectively).

Dr. Obayashi and colleagues summarize, "Elevated CHADS₂ scores were associated with increased ischemic stroke risk and severity in patients with and without atrial fibrillation."

Obayashi Y, et al. Am J Cardiol. 2022; 181: 9-17

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