Factors Associated with Ischaemic Stroke Development Despite Oral Anticoagulant Therapy in Patients with Non-Valvular Atrial Fibrillation
Bibliographic record
Abstract
OBJECTIVE: To evaluate the effectiveness of the most popular risk scores (CHADS2, CHA2DS2-VASc, and ATRIA scores) in predicting stroke events in patients with non-valvular atrial fibrillation (NVAF) who were already receiving oral anticoagulant therapy (OAT). STUDY DESIGN: An observational study. Place and Duration of the Study: Department of Cardiology, Ataturk Research and Training Hospital, Izmir Katip Celebi University, Izmir, Turkiye, from January 2020 to December 2023. METHODOLOGY: Patients with NVAF who were on OAT were divided into two groups. Group 1 consisted of patients who had not experienced a stroke while on OAT, and Group 2 consisted of patients who had experienced at least one stroke while on OAT at the time of inclusion. Continuous variables were presented as mean or median values and were compared using Student's t-test or Mann-Whitney U test, depending on the type of data distribution. RESULTS: There were 162 patients in Group 1 and 129 patients in Group 2, the majority being females. The median age of patients was 76 years (IQR: 71-82) in Group 1 and 75 years (IQR: 68-81) in Group 2. Comorbidities were statistically similar in both groups except for hyperlipidemia. Treatment for atrial fibrillation (AF) was also statistically similar in both groups. The CHA2DS2-VASc and ATRIA stroke scores showed statistically significant differences between the groups. In univariate analysis, hyperlipidemia and ATRIA stroke score were >8, and in multivariate analysis, only ATRIA stroke score was >8, which showed a correlation with estimating the risk of ischaemic stroke (IS) events under oral anticoagulation (OAC). The ATRIA stroke score showed a strong correlation Spearman's rho test and in the ROC curve. CONCLUSION: The CHA2DS2-VASc, CHADS, and ATRIA risk scores have proven effective in primary IS prophylaxis. The ATRIA stroke score system for secondary prevention appears to be more effective than the most popular score systems. KEY WORDS: Non-valvular atrial fibrillation, ATRIA stroke score, CHA2DS2-VASc, Oral anticoagulation, Ischaemic stroke.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".