title: Usefulness of CHADS2 score to predict C-reactive protein, left atrial blood stasis, and prognosis in patients with nonrheumatic atrial fibrillation.
abstract: The CHADS2 score (congestive heart failure, hypertension, age >75 years, diabetes, and previous stroke/transient ischemic attack) is used for embolic risk stratification in patients with atrial fibrillation (AF). Although systemic inflammation is a known predictor of left atrial thrombus formation in patients with nonrheumatic AF, the relation between the CHADS2 score and systemic inflammation is unknown. A total of 165 patients with nonrheumatic AF were enrolled and analyzed. According to the CHADS2 score, the study patients were grouped into low- (score 0 to 1), intermediate- (score 2 to 3), or high- (score 4 to 6) risk categories. The plasma C-reactive protein levels, transesophageal echocardiographic findings, and cardiovascular events (death, stroke, and heart failure) were compared. Patients in the high-risk group had significantly greater C-reactive protein levels than those in the intermediate- and low-risk groups (0.80 mg/dl, range 0.21 to 1.50, vs 0.16 mg/dl, range 0.06 to 0.50, vs 0.08 mg/dl, range 0.04 to 0.21, p <0.01). Using transesophageal echocardiography, the incidence of left atrial spontaneous echo contrast and left atrial thrombus increased with an increasing CHADS2 score. During the follow-up period, the cardiovascular event-free survival was significantly lower in the high-risk group than in the intermediate- or low-risk groups. In conclusion, in patients with nonrheumatic AF, CHADS2 score is related to systemic inflammation, left atrial thrombus formation, and prognosis.
authors.affiliation: Department of Cardiology, Kawasaki Medical School, Kurashiki, Okayama, Japan. tmaehama@med.kawasaki-m.ac.jp
authors.forename: Tomoko
authors.initials: T
authors.lastname: Maehama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Imai
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Yamada
authors.forename: Kikuko
authors.initials: K
authors.lastname: Obase
authors.forename: Ken
authors.initials: K
authors.lastname: Saito
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hayashida
authors.forename: Yoji
authors.initials: Y
authors.lastname: Neishi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kawamoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood / Q000150:complications*; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006325:Heart Atria; D006331:Heart Diseases / Q000209:etiology; D006487:Hemostasis; D006801:Humans; D007249:Inflammation / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012214:Rheumatic Heart Disease; D018570:Risk Assessment; D012720:Severity of Illness Index; D013927:Thrombosis / Q000209:etiology*
chemical_list: D002097:C-Reactive Protein