Prediction Of Thromboembolic Stroke in Non-Valvular Atrial Fibrillation Patients With Low CHA2DS2-VASc Score

Elkot, Moataz A.; Farag, ELsayed M; Shams Eldeen, Mostafa Mahmoud Mohamed; Abomandour, Hala Gouda

doi:10.21608/zumj.2024.274151.3224

Prediction Of Thromboembolic Stroke in Non-Valvular Atrial Fibrillation Patients With Low CHA2DS2-VASc Score

Document Type : Original Article

Authors

¹ Lecturer of cardiology faculty of medicine zagazig university

² cardiology department , faculty of medicine , zagazig university

³ MBBCH, Cardiovascular Department, Nasser institute for research and treatment, Cairo,Egypt

⁴ A. professor

10.21608/zumj.2024.274151.3224

Abstract

Background:Clinical research revealed that thromboembolic events are still a possibility for AF patients with low CHA2DS2-VASc scores

Aim:To assess the ability of certain echocardiographic parameters and laboratory biomarkers to predict thromboembolic events in AF patients with low CHA2DS2-VASc score

Patients and methods: This is a Case-control study at Cardiology Department, Zagazig University Hospitals and Nasser Institute for Research and Treatment ,was conducted on 159 patients: group 1 included 53 non valvular AF patients having low CHA2DS2-VASc score with Acute Ischemic Stroke (AIS), group 2 included 53 non valvular AF patients having low CHA2DS2-VASc score but without AIS and group 3 included 53 controls without AF or AIS. All groups were investigated by certain echocardiography parameters including left atrial emptying fraction(LAEF) , left atrial volume index (LAVI) , left atrial appendage flow velocity(LAA FV) , mitral annular velocity (E′) and E/e′ ratio , also they were investigated by some laboratory markers including platelet count , red cell distribution width(RDW), platelet distribution width(PDW) , creatinine level , D-dimer level and troponin I.

Results:Results: The Receiver Operating Characteristic (ROC) curve analysis showed that several echocardiographic parameters had significant predictive value for stroke ,these parameters were LAVI , LAeF, E/e' ratios, and LAAFV.Also the ROC curve analysis showed that PDW, D-dimer, and troponin had significant predictive value . A novel stroke risk scoring model was developed

Conclusion :The novel stroke risk score model may enhance prediction of LAA thrombus in non valvular AF patients with low CHADS-VASc score (0 in male,1 in female)

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