Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
July 12, 2022BMC Cardiovascular DisordersOpen Access

Novel nomogram outperforms CHA2DS2-VASc for predicting LAAT/SEC with an ~0.89 C-index.

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Existing models have suboptimal ability to predict stroke risk in patients with NVAF, necessitating better tools to identify high-risk individuals.

Does a novel nomogram improve the prediction of left atrial appendage thrombus and spontaneous echo contrast compared to standard risk scores in patients with non-valvular atrial fibrillation?

Population

387 patients with NVAF

Comparison

Developed nomogram vs CHA2DS2, CHA2DS2-VASc, and ATRIA scores

Design

Retrospective cohort study

Key result

A novel nomogram incorporating NT-proBNP, albumin, LAA ejection fraction, and LAA global peak longitudinal strain demonstrated superior discriminative ability for predicting LAAT/SEC compared to the CHA2DS2-VASc score (C-index 0.886 vs 0.579, p<0.05).

Authors

SSShikun SunBSBo SuJLJia Lin

Discussion

Loading...

Member takes

Overview

May refine LAAT/SEC risk assessment in NVAF; leaves open external validation before clinical use.

Study Design

Type

Cohort (n=387)

Multicenter

No

Structured PICO

Does a novel nomogram improve the prediction of left atrial appendage thrombus and spontaneous echo contrast compared to standard risk scores in patients with non-valvular atrial fibrillation?

P
Population
387 patients with non-valvular atrial fibrillation who underwent transesophageal echocardiography, evaluated for predictors of left atrial appendage thrombus and spontaneous echo contrast.
E
Exposure
A prediction nomogram incorporating N-terminal pro-B-type natriuretic peptide (NT-proBNP), albumin (ALB), LAA ejection fraction (LAAEF), and LAA global peak longitudinal strain (LAA GPLS)
C
Comparator
CHA2DS2 score, CHA2DS2-VASc score, and ATRIA score
O
Outcome
Risk of left atrial appendage thrombus (LAAT) and spontaneous echo contrast (SEC)surrogate

Main Result

Absolute Event Rate: 0.886% vs 0.579%

p-value: p=<0.05

A novel nomogram incorporating clinical and echocardiographic parameters significantly improves the prediction of left atrial appendage thrombus and spontaneous echo contrast in NVAF patients compared to traditional clinical risk scores.

Limitations

  • Single center study with a relatively small sample size
  • Limited experimental validation
  • Patients with co-morbidities and in poorer health were excluded due to the invasive nature of the transesophageal echocardiography procedure

Cite This Study

Sun et al. (2022) conducted a cohort in Non-valvular atrial fibrillation (n=387). Nomogram (NT-proBNP, albumin, LAAEF, LAA GPLS) vs. CHA2DS2-VASc score was evaluated on Discriminative ability (C-index) for predicting left atrial appendage thrombus and spontaneous echo contrast (p=<0.05). A novel nomogram incorporating NT-proBNP, albumin, LAA ejection fraction, and LAA global peak longitudinal strain demonstrated superior discriminative ability for predicting LAAT/SEC compared to the CHA2DS2-VASc score (C-index 0.886 vs 0.579, p<0.05).

synapsesocial.com/papers/6aa93b54c924504423cdc952https://doi.org/10.1186/s12872-022-02737-z
View Full Paper
Ask AI
Bookmark
Share