Prediction Of Thromboembolic Stroke in Non-Valvular Atrial Fibrillation Patients With Low CHA2DS2-VASc Score

Background:Clinical research revealed that thromboembolic events are still a possibility for AF patients with low CHA2DS2-VASc scores Aim:To assess the ability of certain echocardiographic parameters and laboratory biomarkers to predict thromboembolic events in AF patients with low CHA2DS2-VASc score Patients and methods: This is a Case-control study at Cardiology Department, Zagazig University Hospitals and Nasser Institute for Research and Treatment ,was conducted on 159 patients: group 1 included 53 non valvular AF patients having low CHA2DS2-VASc score with Acute Ischemic Stroke (AIS), group 2 included 53 non valvular AF patients having low CHA2DS2-VASc score but without AIS and group 3 included 53 controls without AF or AIS. All groups were investigated by certain echocardiography parameters including left atrial emptying fraction(LAEF) , left atrial volume index (LAVI) , left atrial appendage flow velocity(LAA FV) , mitral annular velocity (E′) and E/e′ ratio , also they were investigated by some laboratory markers including platelet count , red cell distribution width(RDW), platelet distribution width(PDW) , creatinine level , D-dimer level and troponin I. Results:Results: The Receiver Operating Characteristic (ROC) curve analysis showed that several echocardiographic parameters had significant predictive value for stroke ,these parameters were LAVI , LAeF, E/e' ratios, and LAAFV.Also the ROC curve analysis showed that PDW, D-dimer, and troponin had significant predictive value . A novel stroke risk scoring model was developed Conclusion :The novel stroke risk score model may enhance prediction of LAA thrombus in non valvular AF patients with low CHADS-VASc score (0 in male,1 in female)