CHA2DS2-VASc Score Is Predictive Of Left Atrial Or Left Atrial Appendage Thrombus In Nonvalvular Atrial Fibrillation

Objective:This study aims to analyze the prediction of CHA2DS2-VASc scores ileft atrial/left appendage (LA/LAA) thrombus formation of nonvalvularatrial fibrillation and investigate the relations of each factor ofCHA2DS2-VASc scores in predicting LA/LAA thrombus formation ofnonvalvular atrial fibrillation.Methods:All datas were collected from the patients who had nonvalvular atrialfibrillation patients and planed to undergo radiofrequency ablation orelectrical cardioversion in cardiovascular medicine of Fujian ProvincialHospital between January2012and December2013, including CHA2DS2-VAScScores (Heart failure, hypertension, age≥75years, diabetes,stroke/TIA,vascular diseases, age from65to74years old, sex),Echocardiography(left atrial diameter), electrocardiography or Holter, chest X-ray,transesophageal echocardiography(TEE), computed tomography Angiography(CTA). Patients were divided into thrombotic group and non-thromboticgroup according to TEE and CTA. We analyzed the relationship betweenCHA2DS2-VASc scores and LA/LAA thrombus formation using linear Chi-squaretest and used X2–test or Fisher exact test to evaluate the frequencydifferences of each factor of CHA2DS2-VASc scores in the two groups.Analysis of variance was applied to appraised the relationship ofCHA2DS2-VASc scores and left atrial diameter and t-test was used toanalyzed the difference in the two groups. The difference detecting LA/LAAthrombus formation between TEE and CTA was evaluated by X2–test(McNemarmethod).At last, we calculated the sensitivity,specificity, the positivepredictive value and the negative predictive value based on the goldstandard using TEE. Results:Among the two hundred and thirty-three patients of nonvalvularatrial fibrillation who was to accept pre-cardioversion, thirteenpatients were diagnoisised with LA/LAA thrombus formation using TEE orCTA. It showed a rising trend in NVAF patients who had LA/LAA thrombusprevalence with the CHA2DS2-VASc scores raised(P<0.05).One patient gotzero among thrombotic group. The statistic was higher in the thromboticgroup who accompainied with hypertension and heart failure than thenon-thrombotic group, but there were no significant differences betweenthe two groups on the other factors. The LAD showed a high trend in thethrombotic one and had statistically significance.Conclusion:With the CHA2DS2-VASc scores increases, the prevalence of LA/LAAThrombus formation in NVAF patients shows a high trend. When theCHA2DS2-VASc scores is zero, it also needs to use TEE or CTA to excludethe LA/LAA thrombus formation. Among the CHA2DS2-VASc scores,Hypertension and heart failure are the risk factors of LA/LAA thrombusFormation. Also,left atrial enlargement shows predictive significance onthe LA/LAA thrombus formation in NVAF patients...