scholarly journals Associations among left atrial thrombus, anticoagulant therapy, and recurrences in patients with nonvalvular atrial fibrillation in the acute phase of thromboembolism

Nosotchu ◽  
2015 ◽  
Vol 37 (6) ◽  
pp. 409-416
Author(s):  
Kazuo Nakajima ◽  
You Higuchi ◽  
Akiko Goto ◽  
Mitsutoshi Morimoto ◽  
Shozo Goto
Keyword(s):  
Atrial Fibrillation ◽  
Acute Phase ◽  
Anticoagulant Therapy ◽  
Left Atrial ◽  
Left Atrial Thrombus ◽  
Nonvalvular Atrial Fibrillation ◽  
Atrial Thrombus

scholarly journals Association of CHADS2and CHA2DS2-VASc Scores with Left Atrial Thrombus with Nonvalvular Atrial Fibrillation: A Single Center Based Retrospective Study in a Cohort of 2695 Chinese Subjects

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
J. Huang ◽  
SL. Wu ◽  
YM. Xue ◽  
HW. Fei ◽  
QW. Lin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Area Under The Curve ◽  
Predictive Ability ◽  
Left Ventricular ◽  
Left Atrial Thrombus ◽  
Nonvalvular Atrial Fibrillation ◽  
Atrial Thrombus

The main mechanism of the CHADS2and CHA2DS2-VASc scores to predict stroke in nonvalvular atrial fibrillation (NVAF) is still controversial. We evaluated the association of the CHADS2and CHA2DS2-VASc scores with left atrial thrombus (LAT) as detected by transesophageal echocardiographic (TEE) and compared the predictive ability of these risk stratification schemes with nonvalvular atrial fibrillation (NVAF). Data from 2,695 consecutive NVAF patients in whom TEE was performed for screening LAT from July 2007 to February 2014 were analyzed. Only 3% of the subjects had LAT. Presence of LAT was not significantly associated with either CHADS2  (P=0.07)or CHA2DS2-VASc score(P=0.12). The area under the curve (AUC) concerning LAT prediction using CHADS2and CHA2DS2-VASc was 0.574 and 0.569, respectively. A composition model includes previous stroke or transient ischemic attack, nonparoxysmal AF, moderate to severe left ventricular systolic dysfunction, left atrial enlargement, and cardiomyopathy which improved the discrimination significantly (AUC = 0.743). In our cohort, both CHADS2and CHA2DS2-VASc scores were of limited value for predicting LAT in patients with NVAF. This questions the CHADS2/CHA2DS2-VASc score predicting stroke mainly through the mechanism of cardiogenic embolism. A scoring scheme combining clinical and echocardiographic parameters may better predict LAT as a surrogate for cardioembolic risk in NVAF patients.

scholarly journals CHA2DS2-VASc Score as a Predictor for Left Atrial Thrombus or Spontaneous Echo Contrast in Patients with Nonvalvular Atrial Fibrillation: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ping Sun ◽  
Zhi Hao Guo ◽  
Hong Bin Zhang
Keyword(s):  
Atrial Fibrillation ◽  
Sensitivity Analysis ◽  
Publication Bias ◽  
Left Atrial ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Left Atrial Thrombus ◽  
Nonvalvular Atrial Fibrillation ◽  
Atrial Thrombus ◽  
Spontaneous Echo Contrast

Objective. This meta-analysis aimed at exploring the predictive value of CHA2DS2-VASc score for the left atrial thrombus (LAT) or left atrial spontaneous echo contrast (LASEC) in patients with nonvalvular atrial fibrillation (NVAF). Methods. PubMed, Embase, Web of Science, ScienceDirect, Cochrane Library, and Chinese core journals of the CNKI and Wanfang databases were searched to identify all the relevant papers that were published up to January 2020. The data were extracted for pooled odds ratios (ORs) with 95% confidence intervals (CIs), heterogeneity, subgroup, publication bias, and sensitivity analysis. Results. Overall, 15 studies containing 6223 patients with NVAF were enrolled. All studies were evaluated for LAT, and 12 studies were evaluated for LASEC. The pooled analysis using a random-effects model showed that a high CHA2DS2-VASc score was related with LAT/LASEC (pooled OR=1.59, 95% CI: 1.35–1.88, P<0.001) with high heterogeneity (I2=76.9%, P<0.001) and LAT (pooled OR=1.83, 95% CI: 1.44–2.33, P<0.001) with high heterogeneity (I2=79.4%, P<0.001). The subgroup analysis demonstrated that the sample size may be the main source of heterogeneity. Although the Begg’s funnel plot based on 15 studies for LAT/LASEC (P=0.029) and 12 studies for LAT (P=0.046) indicated the presence of publication bias among the included studies, the trim-and-fill method verified the stability of the pooled outcomes. In addition, sensitivity analysis indicated that all effects were stable. Conclusion. The results of this meta-analysis showed that the CHA2DS2-VASc score is related with LAT and LASEC in patients with NVAF. However, more studies are warranted to address this issue.

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