Objectives: Left atrial appendage (LAA) morphology is a powerful predictor of thrombogenesis of the left atrium (LA) in patients with non-valvular atrial fibrillation (NVAF). However, it remains unknown whether LAA morphology is useful for stroke risk stratification in patients with NVAF.
Methods: A total of 555 atrial fibrillation patients were divided into thrombus and non-thrombus groups according to transoesophageal echocardiography. We analysed the correlation between LAA morphology and the CHADS score. We determined the LCHADS score and compared the ability to predict LA/LAA thrombosis of the CHADS, LCHADS and CHADS-VASc scores from the area under the curve (AUC).
Results: The odds ratio of non-chicken wing LAA morphology was 11.48. Non-chicken wing LAA morphology was significantly correlated with LA/LAA thrombosis. We incorporated LAA morphology into the CHADS score and named it the LCHADS score. The AUC of the LCHADS score (0.767) in predicting LA/LAA thrombosis was significantly higher than that of the CHADS (0.558) or CHADS-VASc scores (0.557). The positive and negative predictive values of the LCHADS score (13.1 and 98.7%) were higher than those of the CHADS (8.7 and 94.2%) and CHADS-VASc scores (6.9 and 6.9%).
Conclusions: Non-chicken wing LAA morphology was a powerful predictor of LA/LAA thrombosis in NVAF patients. The AUC, sensitivity and specificity of the L CHADS score were higher than those of the CHADS and CHA DS -VASc scores.
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| http://dx.doi.org/10.5830/CVJA-2019-071 | DOI Listing |
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