The role of CHA2DS2-VASc score in assessing risk of left atrial thrombus in patients with nonvalvular atrial fibrillation and risk factors of left atrial thrombosis
Cui Jing
Du Xin
Tang Ribo
Bai Rong
Wu Jiahui
Lyu Qiang
Kang Junping
Ning Man
Dai Tianyi
Sang Caihua
Jiang Chenxi
Long Deyong
Li Songnan
Liu Xiaohui
Dong Jianzeng
Ma Changsheng
Abstract：Objective To investigate the role of CHA2DS2-VASc score in assessing risk of left atrial thrombus in patients with nonvalvular atrial fibrillation(NVAF);to analyze risk factors of left atrial thrombosis.Methods A prospective case-control study was conducted on NVAF patients who were detected left atrial thrombus by transesophageal echocardiography from January 1st,2016 to January 1st,2017 in Beijing Anzhen Hospital,Capital Medical University;56 patients were enrolled in thrombus group and 228 patients were enrolled in non-thrombus group.Clinical data,ultrasonic parameters and CHA2DS2-VASc score were recorded.The relation between CHA2DS2-VASc score and left atrial thrombosis was analyzed.Risk factors of left atrial thrombosis were analyzed.Results Age,CHA2 DS2-VASc score,left atrial diameter(LAD),degrees of mitral regurgitation and tricuspid regurgitation,ratios of permanent atrial fibrillation,heart failure,left ventricular ejection fraction (LVEF) ＜ 50％ and CHA2DS2-VASc score ≥2 points in thrombus group were significantly higher than those in non-thrombus group(P ＜ 0.05).The CHA2 DS2-VASc score of NVAF patients was related to left atrial thrombosis (odds ratio =1.312,95％ confidence interval:1.093-1.577,P =0.004),but multivariate logistic analysis showed that the relation between CHA2 DS2-VASc score and left atrial thrombosis was not significant after adjustment of types of atrial fibrillation(odds ratio =1.077,95 ％ confidence interval:0.850-1.363,P =0.540).With adjustments of atrial fibrillation types and tricuspid regurgitation,multivariate logistic analysis showed that age (65-74 years old,odds ratio =2.323,95％ confidence interval:1.112-4.852,P =0.025;≥75 years old,odds ratio =4.486,95 ％ confidence interval:1.503-11.012,P =0.006),LAD (odds ratio =1.105,95 ％ confidence interval:1.043-1.171,P =0.001) and LVEF ＜ 50％ (odds ratio =3.305,95％ confidence interval:1.045-10.451,P =0.042) were independent risk factors of left atrial thrombosis.Conclusions CHA2DS2-VASc scoring system to assessing risk of thrombus formation in left atrium/auricle is not accurate.Advanced age,left atrial enlargement and decreasing LVEF are independent risk factors of left atrial thrombosis in NVAF patients.
Keywords：Atrial fibrillationLeft atrial(auricle) thrombusCHA2DS2-VASc scoreRisk factors
Publication Date：2017-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 1441-1444 )