Key result
In patients with nonvalvular atrial fibrillation, a CHA2DS2-VASc score of 1 was associated with significantly greater left atrial remodeling, including increased maximum left atrial volume index (40.27 vs 26.79, p=0.002), compared to a score of 0.
Cross-Sectional (n=100)
No
The CHA2DS2-VASc score is better than the CHADS2 score at identifying left atrial remodeling in atrial fibrillation patients presenting with low stroke risk.
Answers are grounded in this paper and cite their sources.
May warrant caution in low-risk AF anticoagulation decisions; leaves open whether CHA2DS2-VASc better identifies remodeling than CHADS2.
BACKGROUND: The CHADS2/CHA2DS2-VASc scores are used to predict thrombo-embolic/stroke in patients with nonvalvular atrial fibrillation (AF). Nevertheless, limited data are available regarding the association between these risk stratification for stroke and left atrial (LA) remodeling status of AF patients. The purpose of this study was to explore the association between these scores and LA remodeling status assessed quantificationally by echocardiography in AF patients. METHODS: One hundred AF patients were divided into 3 groups based on the CHA2DS2-VASc/CHADS2 score: the score of 0 (low stroke risk), the score of 1 (moderate stroke risk) and the score of ≥2 (high stroke risk). All patients were performed through conventional and velocity vector imaging echocardiography. Echocardiographic parameters: maximum LA volume index (LAVImax), LA total emptying fraction (LAEFt) and LA mean strain were obtained to assess quantificationally LA remodeling status. RESULTS: On categorizing with CHA2DS2-VASc, the score of 1 group showed augment in LAVImax and attenuation in LA mean strain derived from VVI, compared with the score of 0 group (LAVImax: 40.27±21.91 vs. 26.79±7.87, p=0.002; LA mean strain: 15.18±6.36 vs. 22±8.54, p=0.001). On categorizing with the CHADS2 score, similar trends were seen between the score of ≥2 and 1 groups (LAVImax: 43.72±13.77 vs. 31.41±9.50, p<0.001; LA mean strain: 11.01±5.31 vs. 18.63±7.00, p<0.001). With multivariate logistic regression, LAVImax (odds ratio: 0.92 , 95% C=I: 0.85 to 0.98, p= 0.01) and LA mean strain reflecting LA remodeling (odds ratio: 1.10, 95% CI: 1.02 to 1.19, p=0.01) were strongly predictive of the CHA2DS2-VASc score of 0. CONCLUSIONS: The superiority of the CHADS2 score may lay in identifying LA remodeling of AF patients with high stroke risk. Whereas, the CHA2DS2-VASc score was better than the CHADS2 score at identifying LA remodeling of AF patients presenting low stroke risk.
No takes yet. Share an insight, caveat, or question.
Li et al. (2013) conducted a cross-sectional in Nonvalvular atrial fibrillation (n=100). CHA2DS2-VASc score of 1 vs. CHA2DS2-VASc score of 0 was evaluated on Maximum left atrial volume index (LAVImax) (p=0.002). In patients with nonvalvular atrial fibrillation, a CHA2DS2-VASc score of 1 was associated with significantly greater left atrial remodeling, including increased maximum left atrial volume index (40.27 vs 26.79, p=0.002), compared to a score of 0.
Synapse has enriched 10 related papers. Consider them for comparative context: