Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2017, Article ID 6839589, 6 pages
https://doi.org/10.1155/2017/6839589
Research Article

Association of CHADS2 and CHA2DS2-VASc Scores with Left Atrial Thrombus with Nonvalvular Atrial Fibrillation: A Single Center Based Retrospective Study in a Cohort of 2695 Chinese Subjects

1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
2School of Public Health, Sun Yat-sen University, Guangdong, China
3School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong

Correspondence should be addressed to SL. Wu; moc.361@icdglsw

Received 10 September 2016; Revised 16 January 2017; Accepted 14 February 2017; Published 8 March 2017

Academic Editor: Christof Kolb

Copyright © 2017 J. Huang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. S. Puwanant, B. C. Varr, K. Shrestha et al., “Role of the CHADS2 score in the evaluation of thromboembolic risk in patients with atrial fibrillation undergoing transesophageal echocardiography before pulmonary vein isolation,” Journal of the American College of Cardiology, vol. 54, no. 22, pp. 2032–2039, 2009. View at Publisher · View at Google Scholar · View at Scopus
  2. E. Zhang, T. Liu, Z. Li, J. Zhao, and G. Li, “High CHA2DS2-VASc score predicts left atrial thrombus or spontaneous echo contrast detected by transesophageal echocardiography,” International Journal of Cardiology, vol. 184, no. 1, pp. 540–542, 2015. View at Publisher · View at Google Scholar · View at Scopus
  3. European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery, A. J. Camm et al., “Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC),” European Heart Journal, vol. 31, no. 19, pp. 2369–2429, 2010. View at Publisher · View at Google Scholar
  4. C. T. January, L. S. Wann, J. S. Alpert et al., “2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American college of Cardiology/American heart association task force on practice guidelines and the heart rhythm society,” Journal of the American College of Cardiology, vol. 64, no. 21, pp. e1–e76, 2014. View at Publisher · View at Google Scholar · View at Scopus
  5. P. Kirchhof, S. Benussi, D. Kotecha et al., “2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS,” European Heart Journal, vol. 37, no. 38, pp. 2893–2962, 2016. View at Google Scholar
  6. Y. D. Kim, M. J. Cha, J. Kim et al., “Increases in cerebral atherosclerosis according to CHADS2 scores in patients with stroke with nonvalvular atrial fibrillation,” Stroke, vol. 42, no. 4, pp. 930–934, 2011. View at Publisher · View at Google Scholar · View at Scopus
  7. M.-J. Cha, Y. D. Kim, H. S. Nam, J. Kim, D. H. Lee, and J. H. Heo, “Stroke mechanism in patients with non-valvular atrial fibrillation according to the CHADS2 and CHA2DS2-VASc scores,” European Journal of Neurology, vol. 19, no. 3, pp. 473–479, 2012. View at Publisher · View at Google Scholar · View at Scopus
  8. I. Deguchi, T. Hayashi, Y. Ohe et al., “CHADS2 score/CHA2DS2-VASc score and major artery occlusion in cardioembolic stroke patients with nonvalvular atrial fibrillation,” International Journal of Stroke, vol. 9, no. 5, pp. 576–579, 2014. View at Publisher · View at Google Scholar · View at Scopus
  9. R. Providência, A. Faustino, L. Paiva et al., “Cardioversion safety in patients with nonvalvular atrial fibrillation: which patients can be spared transesophageal echocardiography?” Blood Coagulation and Fibrinolysis, vol. 23, no. 7, pp. 597–602, 2012. View at Publisher · View at Google Scholar · View at Scopus
  10. R. Providência, L. Paiva, A. Faustino et al., “Cardiac troponin I: prothrombotic risk marker in non-valvular atrial fibrillation,” International Journal of Cardiology, vol. 167, no. 3, pp. 877–882, 2013. View at Publisher · View at Google Scholar · View at Scopus
  11. H. J. Willens, O. Gómez-Marín, K. Nelson, A. Denicco, and M. Moscucci, “Correlation of CHADS2 and CHA2DS2-VASc scores with transesophageal echocardiography risk factors for thromboembolism in a multiethnic united states population with nonvalvular atrial fibrillation,” Journal of the American Society of Echocardiography, vol. 26, no. 2, pp. 175–184, 2013. View at Publisher · View at Google Scholar · View at Scopus
  12. X. Yumei, H. Jun, and W. Shulin, “GW24-e3109correlation of CHADS2 and CHA2DS2-VASc scores with left atrial thrombus in Chinese patients with nonvalvular atrial fibrillation,” Heart, vol. 99, supplement 3, p. A186, 2013. View at Publisher · View at Google Scholar
  13. M. N. Kim, S. A. Kim, J. I. Choi et al., “Improvement of predictive value for thromboembolic risk by incorporating left atrial functional parameters in the CHADS2 and CHA2DS2-VASc scores,” International Heart Journal, vol. 56, no. 3, pp. 286–292, 2015. View at Publisher · View at Google Scholar
  14. B. F. Gage, A. D. Waterman, W. Shannon, M. Boechler, M. W. Rich, and M. J. Radford, “Validation of clinical classification schemes for predicting stroke: results from the national registry of atrial fibrillation,” JAMA, vol. 285, no. 22, pp. 2864–2870, 2001. View at Publisher · View at Google Scholar · View at Scopus
  15. G. Y. H. Lip, R. Nieuwlaat, R. Pisters, D. A. Lane, and H. J. G. M. Crijns, “Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on atrial fibrillation,” Chest, vol. 137, no. 2, pp. 263–272, 2010. View at Publisher · View at Google Scholar · View at Scopus
  16. E. González-Torrecilla, M. A. García-Fernández, E. Pérez-David, J. Bermejo, M. Moreno, and J. L. Delcán, “Predictors of left atrial spontaneous echo contrast and thrombi in patients with mitral stenosis and atrial fibrillation,” The American Journal of Cardiology, vol. 86, no. 5, pp. 529–534, 2000. View at Publisher · View at Google Scholar · View at Scopus
  17. D. Fatkin, R. P. Kelly, and M. P. Feneley, “Relations between left atrial appendage blood flow velocity, spontaneous echocardiographic contrast and thromboembolic risk in vivo,” Journal of the American College of Cardiology, vol. 23, no. 4, pp. 961–969, 1994. View at Publisher · View at Google Scholar · View at Scopus
  18. T. B. Seto, D. A. Taira, J. Tsevat, and W. J. Manning, “Cost-effectiveness of transesophageal echocardiographic-guided cardioversion: a decision analytic model for patients admitted to the hospital with atrial fibrillation,” Journal of the American College of Cardiology, vol. 29, no. 1, pp. 122–130, 1997. View at Publisher · View at Google Scholar · View at Scopus
  19. R. M. Lang, L. P. Badano, V. Mor-Avi et al., “Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging,” Journal of the American Society of Echocardiography, vol. 28, no. 1, pp. 1–39.e14, 2015. View at Publisher · View at Google Scholar
  20. H. Yarmohammadi, B. C. Varr, S. Puwanant et al., “Role of CHADS2 score in evaluation of thromboembolic risk and mortality in patients with atrial fibrillation undergoing direct current cardioversion (from the ACUTE Trial Substudy),” American Journal of Cardiology, vol. 110, no. 2, pp. 222–226, 2012. View at Publisher · View at Google Scholar · View at Scopus
  21. R.-B. Tang, J.-Z. Dong, X.-L. Yan et al., “Serum uric acid and risk of left atrial thrombus in patients with nonvalvular atrial fibrillation,” Canadian Journal of Cardiology, vol. 30, no. 11, pp. 1415–1421, 2014. View at Publisher · View at Google Scholar · View at Scopus
  22. D. Scherr, D. Dalal, K. Chilukuri et al., “Incidence and predictors of left atrial thrombus prior to catheter ablation of atrial fibrillation,” Journal of Cardiovascular Electrophysiology, vol. 20, no. 4, pp. 379–384, 2009. View at Publisher · View at Google Scholar · View at Scopus
  23. J. M. Decker, R. D. Madder, L. Hickman et al., “CHADS2 score is predictive of left atrial thrombus on precardioversion transesophageal echocardiography in atrial fibrillation,” American Journal of Cardiovascular Disease, vol. 1, no. 2, pp. 159–165, 2011. View at Google Scholar
  24. S. Ayirala, S. Kumar, D. M. O'Sullivan, and D. I. Silverman, “Echocardiographic predictors of left atrial appendage thrombus formation,” Journal of the American Society of Echocardiography, vol. 24, no. 5, pp. 499–505, 2011. View at Publisher · View at Google Scholar · View at Scopus
  25. R. Providência, A. Botelho, J. Trigo et al., “Possible refinement of clinical thromboembolism assessment in patients with atrial fibrillation using echocardiographic parameters,” Europace, vol. 14, no. 1, pp. 36–45, 2012. View at Publisher · View at Google Scholar · View at Scopus
  26. H. Yarmohammadi, T. Klosterman, G. Grewal et al., “Efficacy of the CHADS2 scoring system to assess left atrial thrombogenic milieu risk before cardioversion of non-valvular atrial fibrillation,” American Journal of Cardiology, vol. 112, no. 5, pp. 678–683, 2013. View at Publisher · View at Google Scholar · View at Scopus
  27. M. Nishikii-Tachibana, N. Murakoshi, Y. Seo et al., “Prevalence and clinical determinants of left atrial appendage thrombus in patients with atrial fibrillation before pulmonary vein isolation,” American Journal of Cardiology, vol. 116, no. 9, pp. 1368–1373, 2015. View at Publisher · View at Google Scholar · View at Scopus
  28. A. G. Bejinariu, D. U. Härtel, J. Brockmeier, R. Oeckinghaus, A. Herzer, and U. Tebbe, “Left atrial thrombi and spontaneous echo contrast in patients with atrial fibrillation: systematic analysis of a single-center experience,” Herz, vol. 41, no. 8, pp. 706–714, 2016. View at Publisher · View at Google Scholar · View at Scopus
  29. S. Oh, S. J. Kim, S.-K. Ryu et al., “The determinants of stroke phenotypes were different from the predictors (CHADS2 and CHA2DS2-VASc) of stroke in patients with atrial fibrillation: a comprehensive approach,” BMC Neurology, vol. 11, article 107, 2011. View at Publisher · View at Google Scholar · View at Scopus
  30. L. B. Mitchell, D. A. Southern, D. Galbraith et al., “Prediction of stroke or TIA in patients without atrial fibrillation using CHADS2 and CHA2DS2-VASc scores,” Heart, vol. 100, no. 19, pp. 1524–1530, 2014. View at Publisher · View at Google Scholar · View at Scopus
  31. J. H. Svendsen, J. C. Nielsen, S. Darkner, G. V. H. Jensen, L. S. Mortensen, and H. R. Andersen, “CHADS2 and CHA2DS2-VASc score to assess risk of stroke and death in patients paced for sick sinus syndrome,” Heart, vol. 99, no. 12, pp. 843–848, 2013. View at Publisher · View at Google Scholar · View at Scopus
  32. G. Y. H. Lip, H.-J. Lin, K.-L. Chien et al., “Comparative assessment of published atrial fibrillation stroke risk stratification schemes for predicting stroke, in a non-atrial fibrillation population: the Chin-Shan Community Cohort Study,” International Journal of Cardiology, vol. 168, no. 1, pp. 414–419, 2013. View at Publisher · View at Google Scholar · View at Scopus
  33. W. Saliba, N. Gronich, O. Barnett-Griness, and G. Rennert, “The role of CHADS2 and CHA2DS2-VASc scores in the prediction of stroke in individuals without atrial fibrillation: a population-based study,” Journal of Thrombosis and Haemostasis, vol. 14, no. 6, pp. 1155–1162, 2016. View at Publisher · View at Google Scholar · View at Scopus
  34. H. Arima, R. G. Hart, S. Colman et al., “Perindopril-based blood pressure-lowering reduces major vascular events in patients with atrial fibrillation and prior stroke or transient ischemic attack,” Stroke, vol. 36, no. 10, pp. 2164–2169, 2005. View at Publisher · View at Google Scholar · View at Scopus
  35. “Transesophageal echocardiographic correlates of thromboembolism in high-risk patients with nonvalvular atrial fibrillation. The Stroke Prevention in Atrial Fibrillation Investigators Committee on Echocardiography,” Annals of Internal Medicine, vol. 128, no. 8, pp. 639–647, 1998.
  36. V. Thijs and K. Butcher, “Challenges and misconceptions in the aetiology and management of atrial fibrillation-related strokes,” European Journal of Internal Medicine, vol. 26, no. 7, pp. 461–467, 2015. View at Publisher · View at Google Scholar · View at Scopus
  37. A. N. Ganesan, D. P. Chew, T. Hartshorne et al., “The impact of atrial fibrillation type on the risk of thromboembolism, mortality, and bleeding: a systematic review and meta-analysis,” European Heart Journal, vol. 37, no. 20, pp. 1591–1602, 2016. View at Publisher · View at Google Scholar · View at Scopus
  38. L. A. Pearce, “Predictors of thromboembolism in atrial fibrillation: II. Echocardiographic features of patients at risk,” Annals of Internal Medicine, vol. 116, no. 1, pp. 6–12, 1992. View at Publisher · View at Google Scholar · View at Scopus
  39. M. Paciaroni, G. Agnelli, N. Falocci et al., “Prognostic value of trans-thoracic echocardiography in patients with acute stroke and atrial fibrillation: findings From The RAF Study,” Journal of Neurology, vol. 263, no. 2, pp. 231–237, 2016. View at Publisher · View at Google Scholar · View at Scopus