A Study on Etiology, Echocardiographic Parameters, and Stroke Risk Assessment Using CHAD2DS2-VASc Score in Atrial Fibrillation

Abstract

Atrial fibrillation is the most common sustained arrhythmia and its incidence is associated with ischemic stroke, heart failure, and other cardiovascular diseases. It is more common in the patients who are elderly, hypertensive, diabetics, obese or valvular heart disease. In AF patients, the CHA2DS2-VASc score is used to estimate stroke risk, and more recently, LA size has also been suggested as a potential additional factor for stroke in the patients. In this study, the etiology of AF is investigated by the comorbidities and their effect on development of AF, LA size and AF severity and the predictive power of the CHA2DS2-VASc score for stroke risk in 102 AF patients of ASRAM Medical College, Eluru who were evaluated for various comorbidities, echocardiographic parameters (LA size) and CHA2DS2-VASc score to see if there is any correlation with stroke risk. Hypertension, vascular disease (CAD and PAD) and type 2 diabetes mellitus (DM) were the most common comorbidities. LA size was correlated with AF severity and was greater in permanent AF (4.93 cm). In patients with persistent and long standing AF, the CHA2DS2-VASc score was positively correlated with the incidence of stroke. Further additional echocardiographic parameters such as LA size can improve stroke risk stratification, and CHA2DS2-VASc was useful in predicting stroke risk.