Antitrombotik berdasarkan skor CHA2DS2-VASc dan skor HAS BLED terhadap pola pengobatan pada pasien stroke iskemik dengan fibrilasi atrium

Abstract

Stroke associated with atrial fibrillation and cardioembolism tend to manifest more severe, recurrent high risk, and higher mortality. Anticoagulation is recommended in ischemic stroke in atrial fibrillation for prevention, both primary and secondary. Stratification score CHA2DS2-VASc (Congestive Heart Failure, Hypertension, Age ≥ 75, Diabetes, Stroke, Vascular Disease, Sex-Female) is used to select patients at risk of ischemic stroke for the selection of appropriate antithrombotic. The risk of bleeding is measure with HAS BLED (Hypertension, Abnormal liver/ kidney function, Stroke, Bleeding tendency, Elderly, Drug/ Alcohol) score. Previous studies are very limited in research of anti thrombotic use in cardioembolic stroke. Aim this study is Measure the utilization of antittrombothic medication based on CHA2DS2-VASc score and HAS BLED in ischemic stroke patient with atrial fibrillation. This study is a cross sectional. Samples were obtained from the stroke registry and electronic medical records of patients at the Neurology Clinic of Bethesda Hospital Yogyakarta between 2009-2016. Data was analyzed using univariat approach. Data obtained from 77 patients with ischemic stroke in atrial fibrillation which consisted of 33 men (42.8%) and 44 women (57.1%). The largest proportion of patients are aged> 70 years (33.3%). Results of univariate analysis showed that the use of antiplatelet there were 71 (92.2%) patients, the use of anticoagulants 6 (7.7%) patients, as well as a score CHA2DS2-VASc 0 = 3 (3.8%), 1 = 18 (22.5%), ≥2 = 56 (70.1%), the HAS BLED score of 0 = 7 (8.8%), 1 = 27 (33.8%), 2 = 29 (36.3%), 3 = 13 (16.3%), 4 = 1 (1.3%). CHA2DS2-VASc and HAS BLED score are not affect the use of antithrombotic agents for ischemic stroke patient with atrial fibrillation.