Journal of Southern Medical University ›› 2014, Vol. 34 ›› Issue (11): 1601-.

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CHADS2 versus CHA2DS2-VASc scoring systems for predicting left atrial thrombus in
patients with nonvalvular atrial fibrillation

  

  • Online:2014-11-20 Published:2014-11-20

Abstract: Objective To assess the correlation of CHADS2 and CHA2DS2-VASc scores for left atrial thrombus in patients with
nonvalvular atrial fibrillation and the differences in the results between the two scoring systems. Methods A total of 397
patients with nonvalvular atrial fibrillation were enrolled in this study. The CHADS2 and CHA2DS2-VASc scoring systems were
used for evaluating the risk of left atrial thrombus and their differences in the scores and risk stratifications were compared.
The correlation of CHADS2 and CHA2DS2-VASc scores with left atrial thrombus was analyzed. Results The average score of
CHA2DS2-VASc was significantly higher than that of CHADS2 in these patients (1.37±1.19 vs 0.63±0.78, P<0.001). The proportion
of high-risk group was significantly higher (P<0.001) while that of low-risk group significantly lower as stratified by
CHA2DS2-VASc scores than by CHADS2 scores (P<0.001). Transesophageal echocardiography detected left atrial thrombus in 44
of the total patients. The prevalence of left atrial thrombus increased significantly with a higher risk stratification by CHADS2
or CHA2DS2-VASc scores (P<0.05). Univariate analysis showed that female gender, age ≥65 years, left atrium diameter ≥38
mm, left ventricular ejection fraction ≤40%, hypertension, diabetes, coronary heart disease, stroke history, CHADS2≥2, and
CHA2DS2-VASc≥2 were all correlated with left atrial thrombus, but multivariate logistic analysis identified only
CHA2DS2-VASc ≥2 as the independent risk factor for left atrial thrombus (OR=9.85, 95%CI: 2.178-44.542, P<0.01). Conclusion
The average score of CHA2DS2-VASc is higher than that of CHADS2 and has better predictive ability for left atrial thrombus.