Abstract 15857: Risk of Incident Stroke in Aortic Stenosis and Usefulness of the CHA2DS2-VASc Score for Risk Stratification
Introduction: Patients with aortic stenosis (AS) are considered to have an increased risk of ischemic stroke, but data are sparse. Current guidelines recognize AS as an independent risk factor for stroke among atrial fibrillation patients and recommend that all patients should be given oral anticoagulant therapy, irrespectively of other risk factor burden. This is in contrast to patients with non-valvular atrial fibrillation, in whom oral anticoagulant therapy is indicated only if CHA2DS2VASc score exceeds 0.
Hypothesis: We hypothesized that AS confers a risk factor for stroke of comparable magnitude to that observed for non-valvular atrial fibrillation.
Methods and Materials: We employed the Danish nationwide administrative registers (1997-2012) to investigate the association of AS and non-valvular atrial fibrillation with the risk of ischemic stroke, stratified by the CHA2DS2VASc score, among all Danish individuals aged ≥30 years old who did not receive anticoagulation therapy.
Results: Total observation time, numbers of ischemic strokes, and hazard ratio per each 1-point increase in CHA2D2SVASc score for patients with atrial fibrillation, AS, or both are given in the Table.
Conclusion: AS confers a risk factor for stroke of similar magnitude as non-valvular atrial fibrillation and the combination of atrial fibrillation and AS is associated with additionally increased stroke risk. Whether AS patients without atrial fibrillation may benefit from antiplatelet or antithrombotic therapy warrants further studies.
Author Disclosures: C. Andreasen: None. J.L. Jeppesen: None. G.H. Gislason: None. L. Koeber: None. J. Abdulla: None. C. Torp-Pedersen: None. C. Andersson: None.
- © 2016 by American Heart Association, Inc.