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Use of ADAM-C and CHA2DS2-VASc scores to predict complex aortic atheroma after brain ischemia: A prospective

Florence Nicot1, Clément Charbonnel1, Christophe Jego2

  • 1Department of Cardiology, Versailles Hospital, Le Chesnay, France.

Echocardiography (Mount Kisco, N.Y.)
|March 25, 2021
PubMed

Insights

The CHA2DS2-VASc and ADAM-C scores can predict complex aortic atheroma (CAA) after brain ischemia (BI). Both scores, particularly with values below 2 and 3 respectively, show a high negative predictive value for detecting CAA.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Medical Diagnostics

Background:

  • Complex aortic atheroma (CAA) is a significant cause of acute brain ischemia (BI), including stroke and TIA.
  • CAA is linked to recurrent cerebrovascular events.
  • Existing risk scores like CHA2DS2-VASc have shown utility beyond atrial fibrillation.

Purpose of the Study:

  • To evaluate the predictive capability of the CHA2DS2-VASc score for CAA in patients with BI.
  • To assess the efficacy of the ADAM-C score in predicting CAA after BI.
  • To compare the performance of CHA2DS2-VASc and ADAM-C scores in identifying CAA.

Main Methods:

  • A prospective, multicenter, observational study involving 1479 adult patients hospitalized for BI.
  • CAA was defined by the presence of thrombus, ulcerated plaque, or plaque thickening ≥ 4 mm.
  • Statistical analysis was performed to compare risk scores between patients with and without CAA.

Main Results:

  • CAA was diagnosed in 14.6% of patients.
  • Both CHA2DS2-VASc and ADAM-C scores were significantly higher in patients with CAA (P < .0001).
  • The scores demonstrated good predictive ability for CAA (AUCs 0.699 and 0.759, respectively), with high negative predictive values (96%).

Conclusions:

  • CHA2DS2-VASc and ADAM-C scores are effective predictors of CAA following BI.
  • A CHA2DS2-VASc score < 2 and an ADAM-C score < 3 both offer a high negative predictive value (96%) for ruling out CAA.
  • These scores can aid in the risk stratification of patients with BI.
Abstract

Keywords:
CHA2DS2-VASc scorecomplex aortic atheromastroketransesophageal echocardiography

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