Abstract 9099: Echocardiographic Score versus Conventional Clinical Risk Score to Predict Thromboembolic Events at Younger Ages or First Thromboembolic Events in Patients with Non-valvular Atrial Fibrillation in Japan: The Fushimi AF Registry

Abstract

Introduction: In patients with atrial fibrillation (AF), age and history of stroke are the strongest risk factors of thromboembolism events (TE). However, in patients with AF, especially in those with younger age or without previous TEs, preventing TEs is of clinical importance. We reported that echocardiographic (Echo) parameters such as enlarged left atrial diameter (LAD) or increased relative wall thickness (RWT) of left ventricle (LV) or smaller LV end-diastolic diameter (LVDd) were associated with incidence of TEs. We assessed whether the score based on Echo parameters (Echo score) can discriminate TEs, and compared its performance with a conventional clinical risk score. Methods: In the Fushimi AF Registry, follow-up data were available for 4,472 patients. Of them, Echo data at enrollment were available for 3,246 patients with non-valvular AF (NVAF). We investigated the relationship between Echo score [RWT ≥0.409, LVDd <50 mm, LAD >45 mm, each 1 point] and incidence of ischemic stroke (IS)/systemic embolism (SE) during 3 year follow-up in all patients, and patients with younger age and without previous stroke/SE, respectively. Results: During the median follow-up period of 1,095 days, 149 IS/SE events occurred. The incidence of IS/SE according to the groups stratified by Echo score is shown (Figure). Even in those with younger age or without previous stroke/SE, Echo score nicely discriminated the risk of TEs and the c-statistic was higher than that of CHA 2 DS 2 -VASc score (Table). Conclusions: Echo score better discriminated TEs in NVAF patients even with younger age or without previous TEs, than CHA 2 DS 2 -VASc score. Further research is needed to generalize the result.