| CHADS(2) score is predictive of left atrial thrombus on precardioversion transesophageal echocardiography in atrial fibrillation. | |
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MedLine Citation:
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PMID: 22254195 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: The goals of this study were to determine: 1) if the CHADS(2) score correlates with left atrial (LA) or left atrial appendage (LAA) thrombus on pre-cardioversion transesophageal echocardiography (TEE) in nonvalvular atrial fibrillation (NVAF); and 2) what, if any, components of the CHADS(2) score are most important in predicting LA/LAA thrombus. BACKGROUND: It is unknown if CHADS(2) score, a marker of thromboembolic risk in NVAF, accurately predicts LA/LAA thrombus on pre-cardioversion TEE. METHODS: We retrospectively studied patients undergoing precardioversion TEE for NVAF at a tertiary hospital. TEE reports were reviewed for presence of LA/LAA thrombus. Using medical records and an ICD-9 coding database, a CHADS(2) score was derived, and the association between CHADS(2) and thrombus was evaluated with Mantel-Haenszel Chi-Square. The relation between the singular components of CHADS(2) and thrombus were analyzed using Pearson's Chi-Square. RESULTS: In 643 consecutive patients undergoing pre-cardioversion TEE, LA/LAA thrombus was identified in 46 (7.2 %). A strong association was present between CHADS(2)score and LA/LAA thrombus (p = 0.0005). No thrombi were identified in patients with CHADS(2) = 0. Among 46 patients with thrombus, all (100%) had CHF. Of the singular components, CHF was the only factor independently associated with thrombus (p < 0.0001). CONCLUSIONS: In non-valvular atrial fibrillation, CHADS(2) is strongly associated with LA thrombus on TEE. Our findings suggest pre-cardioversion TEE may be unnecessary if the CHADS(2) score = 0. Of the components of the CHADS(2) score, CHF was the only independently associated risk factor which correlated with LA/LAA thrombus. |
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Authors:
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Jeffrey M Decker; Ryan D Madder; Leaden Hickman; Victor Marinescu; Anna Marandici; Shaheena Raheem; Lynn M Carlyle; Richard Van Dam; Judith A Boura; David E Haines |
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Publication Detail:
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Type: Journal Article Date: 2011-07-28 |
Journal Detail:
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Title: American journal of cardiovascular disease Volume: 1 ISSN: 2160-200X ISO Abbreviation: Am J Cardiovasc Dis Publication Date: 2011 |
Date Detail:
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Created Date: 2012-01-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101569582 Medline TA: Am J Cardiovasc Dis Country: United States |
Other Details:
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Languages: eng Pagination: 159-65 Citation Subset: - |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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