TY - JOUR T1 - Atrial fibrillation type and renal dysfunction as important predictors of left atrial thrombus JF - Heart JO - Heart SP - 1310 LP - 1315 DO - 10.1136/heartjnl-2018-314492 VL - 105 IS - 17 AU - Agnieszka Kapłon-Cieślicka AU - Monika Budnik AU - Monika Gawałko AU - Michał Peller AU - Iwona Gorczyca AU - Anna Michalska AU - Aldona Babiarz AU - Aleksandra Bodys AU - Robert Uliński AU - Maciej Żochowski AU - Piotr Scisło AU - Janusz Kochanowski AU - Krzysztof J Filipiak AU - Grzegorz Opolski Y1 - 2019/09/01 UR - http://heart.bmj.com/content/105/17/1310.abstract N2 - Objective We aimed to identify predictors of left atrial appendage (LAA) thrombus in patients with atrial fibrillation (AF) and to enhance the prognostic value of the CHA2DS2-VASc score.Methods Derivation cohort included 1033 consecutive AF patients referred for catheter ablation or direct current cardioversion, in whom transoesophageal echocardiography (TOE) was performed prior to the procedure. Logistic regression analysis was used to identify predictors of LAA thrombus on TOE. Receiver operating characteristic (ROC) curves were constructed to compare the newly developed score with the CHA2DS2 and CHA2DS2-VASc scores in the derivation and the validation (n=320) cohort.Results On TOE, LAA thrombus was present in 59 (5.7%) patients in the derivation cohort. Aside from variables encompassed by the CHA2DS2-VASc score, LAA thrombus predictors included AF type (persistent/’permanent’ vs paroxysmal) and renal dysfunction. These predictors were incorporated into the CHA2DS2-VASc score. In ROC analysis, area under the curve (AUC) for the new score (CHA2DS2-VASc-RAF score) was significantly higher (0.81) than those for the CHA2DS2 and CHA2DS2-VASc scores (0.71 and 0.70, respectively). In the validation cohort, the CHA2DS2-VASc-RAF score also performed significantly better (AUC of 0.88) than the CHA2DS2 and CHA2DS2-VASc scores (AUC of 0.63 and 0.60, respectively).Conclusion In real-world AF patients with majority on oral anticoagulation, LAA thrombus was found in approximately 6%. Two variables not included in the CHA2DS2-VASc score (AF type and renal dysfunction) proved strong, independent predictors of LAA thrombus and might improve thromboembolic risk stratification. ER -