title: The CHA2DS2-VASc score as a predictor of left atrial thrombus in patients with non-valvular atrial fibrillation.
abstract: OBJECTIVE
  To investigate whether or not the CHA2DS2-VASc score predicts left atrial (LA) thrombus detected on pre-cardioversion transoesophageal echocardiography (TEE).
  
  
  METHODS
  The medical records of patients who had undergone TEE were reviewed to assess the presence of LA thrombus prior to direct-current cardioversion for atrial fibrillation (AF). The CHA2DS2-VASc score was calculated for each patient. Clinical TEE reports were reviewed for the presence of LA thrombus. Patients with a valve prosthesis or rheumatic mitral valve disease were excluded from this study.
  
  
  RESULTS
  A total of 309 patients were identified. The mean age was 70.1 ± 9.8 years and 151 (49%) patients were males and 158 (51%) were females. LA thrombus was seen in 32 (10.3%) of the 309 patients. Fifty (16.2%) patients had a low CHA2DS2-VASc score (0-1), 230 (74.4%) had an intermediate score (2-4) and 29 (9.4%) had a high score (5-9). The incidence of LA thrombus in the low, intermediate and high CHA2DS2-VASc score groups was 0, 4.4 and 68.7%, respectively. The LA thrombus risk increased with increasing CHA2DS2-VASc scores. On multivariate logistic analysis, the CHA2DS2-VASc score (OR 3.26, 95% CI 2.3-4.65; p = 0.001) and age (OR 0.93, 95% CI 0.88-0.98; p = 0.004) were independent risk factors for LA thrombus in patients with non-valvular AF.
  
  
  CONCLUSIONS
  A high CHA2DS2-VASc score was independently associated with the presence of LA thrombus in patients with non-valvular AF.
authors.affiliation: Cardiology Department, Gulhane Military Medical Academy, Haydarpaşa Training Hospital, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Uz
authors.forename: Murat
authors.initials: M
authors.lastname: Atalay
authors.forename: Mehmet
authors.initials: M
authors.lastname: Doğan
authors.forename: Zafer
authors.initials: Z
authors.lastname: Isilak
authors.forename: Murat
authors.initials: M
authors.lastname: Yalcin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Uzun
authors.forename: Ejder
authors.initials: E
authors.lastname: Kardesoglu
authors.forename: Bekir Sitki
authors.initials: BS
authors.lastname: Cebeci
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D017548:Echocardiography, Transesophageal; D004554:Electric Countershock; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013927:Thrombosis / Q000209:etiology*
references.citation: J Am Coll Cardiol. 2001 Mar 1;37(3):691-704
references.pmid: 11693739
references.citation: J Am Soc Echocardiogr. 2013 Feb;26(2):175-84
references.pmid: 23253435
references.citation: Thromb Haemost. 2011 Jun;105(6):1107-9
references.pmid: 21544316
references.citation: Thromb Haemost. 2011 Sep;106(3):528-38
references.pmid: 21800003
references.citation: Circ Arrhythm Electrophysiol. 2012 Apr;5(2):319-26
references.pmid: 22319004
references.citation: J Am Coll Cardiol. 2009 Nov 24;54(22):2032-9
references.pmid: 19926009
references.citation: Am J Cardiol. 2012 Feb 15;109(4):550-5
references.pmid: 22133753
references.citation: Ann Intern Med. 1997 Feb 1;126(3):200-9
references.pmid: 9027270
references.citation: Med Princ Pract. 2011;20(5):464-9
references.pmid: 21757938
references.citation: Chest. 2010 Feb;137(2):263-72
references.pmid: 19762550
references.citation: JAMA. 2001 Jun 13;285(22):2864-70
references.pmid: 11401607
references.citation: Am J Cardiovasc Dis. 2011;1(2):159-65
references.pmid: 22254195
references.citation: Eur Heart J. 2013 Jan;34(3):170-6
references.pmid: 23018151
references.citation: Am J Cardiol. 2010 Aug 15;106(4):535-8
references.pmid: 20691312
references.citation: Am J Cardiol. 2012 Jul 15;110(2):222-6
references.pmid: 22503581
references.citation: Eur J Echocardiogr. 2009 May;10(3):383-8
references.pmid: 18835820
references.citation: Rev Port Cardiol. 2013 May;32(5):373-8
references.pmid: 23566635
references.citation: Europace. 2012 Oct;14(10):1385-413
references.pmid: 22923145
references.citation: Clin Res Cardiol. 2013 Feb;102(2):139-44
references.pmid: 22983022
references.citation: Thromb Haemost. 2012 Jun;107(6):1172-9
references.pmid: 22473219
references.citation: Circulation. 2009 Apr 14;119(14):e391-479
references.pmid: 19324966
references.citation: J Am Coll Cardiol. 2008 Feb 26;51(8):810-5
references.pmid: 18294564