Related Experiment Video

Updated: May 7, 2026

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

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.3K

Left Atrial Dimension and CHA2DS2-VASc Score in Predicting Stroke in Patients with Rheumatic Atrial Fibrillation

Sheng-Nan Chang1, Chih-Hsien Wang2, Yoga Waranugraha3,4

  • 1Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.

JACC. Advances
|January 16, 2025
PubMed

Insights

Rheumatic atrial fibrillation (AF) patients face higher stroke risks. The CHA2DS2-VASc-LA score may improve stroke risk assessment in this population, offering better prediction than the standard CHA2DS2-VASc score.

Area of Science:

  • Cardiology
  • Stroke Prevention
  • Atrial Fibrillation Research

Background:

  • Rheumatic atrial fibrillation (AF) patients have an increased risk of stroke.
  • Identifying accurate risk factors for stroke in this population is crucial.
  • Existing risk scores may not fully capture the stroke risk in rheumatic AF.

Purpose of the Study:

  • To evaluate the predictive performance of the CHA2DS2-VASc score for stroke events in rheumatic AF patients.
  • To explore enhancements to the CHA2DS2-VASc score for improved stroke risk prediction in Asian populations.
  • To compare the predictive accuracy between rheumatic AF and nonvalvular AF.

Main Methods:

  • A retrospective cohort study of 29,341 AF patients from March 2010 to December 2020.
  • Included 1,942 patients with rheumatic AF, assessing ischemic stroke as the endpoint.
  • Utilized the area under the receiver operating characteristic curve (AUC) to evaluate the CHA2DS2-VASc score's performance.

Main Results:

  • Rheumatic AF patients had a higher stroke incidence than nonvalvular AF patients (P=0.048).
  • The CHA2DS2-VASc score showed lower predictive accuracy in rheumatic AF (AUC=0.693) compared to nonvalvular AF (AUC=0.746).
  • Integrating left atrial (LA) dimension improved AUC for rheumatic AF (0.707), correlating with stroke incidence (P=0.012).

Conclusions:

  • Rheumatic AF patients exhibit a significantly higher stroke risk.
  • The CHA2DS2-VASc-LA score demonstrates potential for enhanced stroke risk assessment in rheumatic AF.
  • Further validation of the CHA2DS2-VASc-LA score is warranted for clinical application.
Abstract

Keywords:
CHA2DS2-VASc scoreatrial fibrillationrheumatic heart diseasestroke

More Related Videos

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

3.6K
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

1.6K

Related Concept Videos

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...