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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

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CHA2DS2-VASc score, left atrial size and atrial fibrillation as stroke risk factors in the Tromsø Study

Sweta Tiwari1, Maja-Lisa Løchen1, Bjarne K Jacobsen1

  • 1Department of Community Medicine , UiT The Arctic University of Norway , Tromsø , Norway.

Open Heart
|September 14, 2016
PubMed

Insights

The CHA2DS2-VASc score combined with left atrial size significantly predicts stroke risk, even without atrial fibrillation. Enlarged left atrial size amplifies stroke odds in individuals with a CHA2DS2-VASc score of 1 or higher.

Area of Science:

  • Cardiology
  • Neurology
  • Epidemiology

Background:

  • Atrial fibrillation (AF), left atrial (LA) size, and CHA2DS2-VASc scores are individually linked to stroke risk.
  • Predictive models for stroke often consider these factors separately.

Purpose of the Study:

  • To evaluate the combined predictive power of CHA2DS2-VASc score, LA size, and AF status for incident stroke.
  • To identify high-risk individuals for stroke using combined risk factors.

Main Methods:

  • A population-based cohort study followed 2844 participants from the Tromsø Study (1994-2012).
  • Baseline data included LA size and CHA2DS2-VASc scores; AF status was obtained from medical records.
  • Multivariate logistic regression analyzed the association between covariates and stroke outcomes.

Main Results:

  • 325 strokes occurred; incidence rates were 6.4/1000 person-years for women and 8.4/1000 person-years for men.
  • Participants with CHA2DS2-VASc score ≥1 and LA size <2.8 had ~4x increased stroke odds.
  • Participants with CHA2DS2-VASc score ≥1 and LA size ≥2.8 had ~9x increased stroke odds, irrespective of AF status.

Conclusions:

  • Combining CHA2DS2-VASc score ≥1 with enlarged LA size effectively identifies individuals at high risk of stroke.
  • This combination improves stroke risk prediction, particularly in those without diagnosed atrial fibrillation.
Abstract

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