Arrhythmias & electrophysiology
Left Atrial Dimension and CHA2DS2-VASc Score in Predicting Stroke in Patients with Rheumatic Atrial Fibrillation
Authors' conclusion
Rheumatic AF patients have a higher stroke risk than nonrheumatic AF and CHA2DS2-VASc-LA score might improve stroke risk assessment in this population.
Study context
- Population
- Atrial fibrillation (AF) patients, Asian population, March 2010 to December 2020, follow-up up to 10 years1,942 rheumatic AF
- Participants
- 29,341 patients
- Exposure
- Rheumatic AF vs nonvalvular AF; CHA2DS2-VASc with vs without left atrial (LA) dimension
- Rheumatic AFn = 1,942
- Outcome
- Ischemic stroke; predictive performance of CHA2DS2-VASc (AUC)
Main finding
As reported in the abstract
CHA2DS2-VASc AUC for stroke
| Group | AUC | AUC with LA |
|---|---|---|
| Rheumatic AF | 0.693 | 0.707 |
| Nonvalvular AF | 0.746 | 0.734 |
AUC
Rheumatic AF0.693
Nonvalvular AF0.746
AUC with LA
Rheumatic AF0.707
Nonvalvular AF0.734
- Rheumatic AF vs Nonvalvular AF: P < 0.001 — 0.693 vs 0.746
- Adding LA dimension, rheumatic AF: trend toward increased AUC
- P = 0.068
- Adding LA dimension, nonvalvular AF: no increase in AUC
- P = 0.744
Observational data: associations, not effects.
Further findings
Stroke incidence
- Higher stroke incidence in rheumatic AF than nonvalvular AF
- log-rank P = 0.048
CHA2DS2-VASc-LA score vs annual ischemic stroke incidence (rheumatic AF)
- Robust correlation
- P = 0.012 for trend
Original publication
Left Atrial Dimension and CHA2DS2-VASc Score in Predicting Stroke in Patients with Rheumatic Atrial Fibrillation. JACC Adv. Published 30 October 2024. doi:10.
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