The CHA2DS2-VASc Score As a Predictor of Left Atrial Thrombus in Patients with Non-valvular Atrial Fibrillation

Overview

Journal Med Princ Pract

Publisher Karger

Specialties General Medicine
Medical Education

Date 2014 Apr 23

PMID 24751402

Citations 15

Authors

Omer Uz

Murat Atalay

Mehmet Dogan

Zafer Isilak

Murat Yalcin

Mehmet Uzun

Ejder Kardesoglu

Bekir Sitki Cebeci

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate whether or not the CHA2DS2-VASc score predicts left atrial (LA) thrombus detected on pre-cardioversion transoesophageal echocardiography (TEE).

Materials And Methods: The medical records of patients who had undergone TEE were reviewed to assess the presence of LA thrombus prior to direct-current cardioversion for atrial fibrillation (AF). The CHA2DS2-VASc score was calculated for each patient. Clinical TEE reports were reviewed for the presence of LA thrombus. Patients with a valve prosthesis or rheumatic mitral valve disease were excluded from this study.

Results: A total of 309 patients were identified. The mean age was 70.1 ± 9.8 years and 151 (49%) patients were males and 158 (51%) were females. LA thrombus was seen in 32 (10.3%) of the 309 patients. Fifty (16.2%) patients had a low CHA2DS2-VASc score (0-1), 230 (74.4%) had an intermediate score (2-4) and 29 (9.4%) had a high score (5-9). The incidence of LA thrombus in the low, intermediate and high CHA2DS2-VASc score groups was 0, 4.4 and 68.7%, respectively. The LA thrombus risk increased with increasing CHA2DS2-VASc scores. On multivariate logistic analysis, the CHA2DS2-VASc score (OR 3.26, 95% CI 2.3-4.65; p = 0.001) and age (OR 0.93, 95% CI 0.88-0.98; p = 0.004) were independent risk factors for LA thrombus in patients with non-valvular AF.

Conclusion: A high CHA2DS2-VASc score was independently associated with the presence of LA thrombus in patients with non-valvular AF.

Citing Articles

Characteristics, Thrombus Resolution, and Long-Term Outcomes in Patients with Nonvalvular Atrial Fibrillation and Atrial Thrombus.

Yang S, Zhang Y, Chen N, Shi J, Ju W, Chen H Clin Appl Thromb Hemost. 2023; 29:10760296231168097.

PMID: 37079758 PMC: 10126607. DOI: 10.1177/10760296231168097.

The predictive value of the systemic immune-inflammatory index for left atrial appendage thrombus in non-valvular atrial fibrillation.

Koca F, Levent F, Sensoy B, Tenekecioglu E Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023; 167(2):162-168.

PMID: 36756877 DOI: 10.5507/bp.2023.007.

Clinical Features Associated with 'Normal Range' Fibrin D-Dimer Levels in Atrial Fibrillation Patients with Left Atrial Thrombus.

Bai Y, Luo S, Liu S, Gong L, Zhong P, Wang Z Clin Appl Thromb Hemost. 2022; 28:10760296221133380.

PMID: 36523145 PMC: 9768829. DOI: 10.1177/10760296221133380.

Electric cardioversion in patients treated with oral anticoagulants: embolic material in the left atrial appendage.

Karwowski J, Rekosz J, Solecki M, Maczynska-Mazuruk R, Wrzosek K, Suminska-Syska J Cardiovasc J Afr. 2022; 34(3):181-188.

PMID: 36478018 PMC: 10658724. DOI: 10.5830/CVJA-2022-060.

Left atrial appendage thrombus in patients with atrial fibrillation who underwent oral anticoagulation.

Karwowski J, Rekosz J, Maczynska-Mazuruk R, Wiktorska A, Wrzosek K, Loska W Cardiol J. 2022; 31(3):461-471.

PMID: 35703043 PMC: 11229796. DOI: 10.5603/CJ.a2022.0054.

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