RT Journal Article SR Electronic T1 Atrial fibrillation type and renal dysfunction as important predictors of left atrial thrombus JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 1310 OP 1315 DO 10.1136/heartjnl-2018-314492 VO 105 IS 17 A1 Kapłon-Cieślicka, Agnieszka A1 Budnik, Monika A1 Gawałko, Monika A1 Peller, Michał A1 Gorczyca, Iwona A1 Michalska, Anna A1 Babiarz, Aldona A1 Bodys, Aleksandra A1 Uliński, Robert A1 Żochowski, Maciej A1 Scisło, Piotr A1 Kochanowski, Janusz A1 Filipiak, Krzysztof J A1 Opolski, Grzegorz YR 2019 UL http://heart.bmj.com/content/105/17/1310.abstract AB 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.