Background
Materials and methods
Study population
Echocardiography
Thromboembolic risk scores
Clinical definitions
Statistical analysis
Results
Clinical and echocardiographic characteristics of the patient groups
Parameters | CHADS2 group (n = 349) | CHA2DS2-VASc group (n = 221) | P |
---|---|---|---|
Age (years) | 65 ± 10 | 62 ± 11 | 0.012 |
Female, n (%) | 93 (27) | 39 (18) | 0.005 |
Paroxysmal AF, n (%) | 249 (71) | 169 (76) | 0.18 |
CHADS2 score | 0.64 ± 0.48 | 0.47 ± 0.50 | < 0.001 |
0 | 124 (36) | 118 (53) | |
1 | 225 (64) | 103 (47) | < 0.001 |
CHA2DS2-VASc score | 1.27 ± 0.86 | 0.71 ± 0.45 | < 0.001 |
0 | 63 (18) | 63 (29) | |
1 | 158 (45) | 158 (71) | |
2 | 99 (28) | 0 (0) | |
3 | 28 (8) | 0 (0) | |
4 | 1 (0) | 0 (0) | < 0.001 |
HAS-BLED score | 0.44 ± 0.66 | 0.35 ± 0.59 | 0.11 |
Congestive heart failure, n (%) | 56 (16) | 28 (13) | 0.26 |
Hypertension, n (%) | 131 (38) | 66 (30) | 0.059 |
Age 65–75, n (%) | 135 (39) | 47 (21) | < 0.001 |
Age ≥ 75 years, n (%) | 20 (6) | 0 (0) | < 0.001 |
Diabetes mellitus, n (%) | 15 (4) | 6 (3) | 0.32 |
Dyslipidemia, n (%) | 64 (18) | 41 (19) | 0.95 |
Stroke/TIA, n (%) | 0 (0) | 0 (0) | – |
Vascular disease, n (%) | 9 (3) | 0 (0) | 0.003 |
eGFR (mL/min/1.73m2) | 68 ± 16 | 69 ± 15 | 0.55 |
eGFR < 60 mL/min/1.73m2, n (%) | 88 (25) | 53 (24) | 0.51 |
BNP (pg/mL) | 93 ± 257 | 80 ± 201 | 0.53 |
BNP ≥200 pg/mL, n (%) | 30 (9) | 17 (8) | 0.70 |
Anticoagulation, n (%) | 338 (97) | 215 (97) | |
Warfarin, n (%) | 96 (28) | 67 (30) | |
DOACs, n (%) | 242 (69) | 148 (67) | 0.93 |
Echocardiography | |||
LA diameter (mm) | 42 ± 7 | 41 ± 7 | 0.22 |
LA diameter ≥ 50 mm, n (%) | 46 (13) | 22 (10) | 0.24 |
LV end-diastolic dimension (mm) | 48 ± 6 | 48 ± 6 | 0.81 |
LV end-systolic dimension (mm) | 31 ± 7 | 31 ± 6 | 0.99 |
LVEF (%) | 62 ± 8 | 62 ± 7 | 0.64 |
LVEF< 50%, n (%) | 18 (5) | 10 (5) | 0.73 |
Thickness of IVS (mm) | 9 ± 2 | 9 ± 2 | 0.89 |
Thickness of LV posterior wall (mm) | 9 ± 1 | 9 ± 1 | 0.85 |
LV mass (g) | 159 ± 46 | 160 ± 48 | 0.89 |
LV mass index (g/m2) | 93 ± 24 | 92 ± 25 | 0.80 |
LV hypertrophy, n (%) | 86 (25) | 47 (21) | 0.35 |
More-than-mild MR, n (%) | 17 (5) | 9 (4) | 0.88 |
LAA velocity (cm/s) | 58 ± 28 | 61 ± 28 | 0.26 |
LAA velocity < 20 cm/s, n (%) | 18 (5) | 9 (4) | 0.55 |
LASEC, n (%) | 77 (22) | 41 (19) | 0.31 |
LA thrombus, n (%) | 1 (0) | 0 (0) | 0.32 |
Determinants of LASEC
CHADS2 group | CHA2DS2-VASc group | |||||
---|---|---|---|---|---|---|
Parameters | Odds ratio | 95% CI | P | Odds ratio | 95% CI | P |
Female | 1.56 | 0.91–2.70 | 0.11 | 1.99 | 0.89–4.43 | 0.092 |
Non-paroxysmal AF | 7.00 | 4.04–12.2 | < 0.001 | 4.40 | 2.14–9.07 | < 0.001 |
eGFR < 60 mL/min/1.73m2 | 2.18 | 1.27–3.76 | 0.005 | 1.63 | 0.77–3.43 | 0.20 |
BNP ≥200 pg/mL | 6.61 | 3.02–14.5 | < 0.001 | 4.61 | 1.66–12.8 | 0.003 |
LA diameter ≥ 50 mm | 3.71 | 1.94–7.09 | < 0.001 | 3.61 | 1.42–9.16 | 0.007 |
LVEF < 50% | 8.18 | 2.96–22.6 | < 0.001 | 7.54 | 2.02–28.1 | 0.003 |
LV hypertrophy | 3.35 | 1.95–5.75 | < 0.001 | 3.08 | 1.47–6.43 | 0.003 |
CHADS2 group | CHA2DS2-VASc group | |||||
---|---|---|---|---|---|---|
Parameters | Odds ratio | 95% CI | P | Odds ratio | 95% CI | P |
Female | – | – | – | – | – | – |
Non-paroxysmal AF | 5.65 | 3.08–10.5 | < 0.001 | 3.38 | 1.51–7.54 | 0.003 |
eGFR < 60 mL/min/1.73m2 | 1.76 | 0.93–3.34 | 0.082 | – | – | – |
BNP ≥200 pg/mL | 3.42 | 1.29–9.06 | 0.013 | 1.76 | 0.49–6.33 | 0.39 |
LA diameter ≥ 50 mm | 1.38 | 0.63–3.03 | 0.42 | 1.42 | 0.48–4.20 | 0.53 |
LVEF < 50% | 2.53 | 0.71–9.09 | 0.15 | 3.10 | 0.63–15.4 | 0.17 |
LV hypertrophy | 2.26 | 1.19–4.28 | 0.013 | 2.53 | 1.13–5.70 | 0.025 |
Discussion
Previous studies on LASEC and thromboembolic risk scores
LASEC occurrence under low TE risk scores
CHADS2 group | CHA2DS2-VASc group | |||||
---|---|---|---|---|---|---|
Parameters | LASEC absent (n = 272) | LASEC present (n = 77) | P | LASEC absent (n = 180) | LASEC present (n = 41) | P |
Congestive heart failure, n (%) | 26 (10) | 30 (39) | < 0.001 | 13 (7) | 15 (37) | < 0.001 |
Hypertension, n (%) | 104 (38) | 27 (35) | 0.61 | 57 (32) | 9 (22) | 0.21 |
Age 65–75 | 104 (37) | 32 (40) | 0.64 | 41 (22) | 6 (14) | 0.21 |
Age ≥ 75 years, n (%) | 17 (6) | 3 (4) | 0.41 | 0 (0) | 0 (0) | – |
Diabetes mellitus, n (%) | 14 (5) | 1 (1) | 0.10 | 6 (3) | 0 (0) | 0.11 |
Stroke/TIA, n (%) | 0 (0) | 0 (0) | – | 0 (0) | 0 (0) | – |
Vascular disease, n (%) | 5 (2) | 4 (5) | 0.13 | 0 (0) | 0 (0) | – |
Female, n (%) | 67 (24) | 26 (34) | 0.12 | 28 (16) | 11 (27) | 0.10 |