Editorial to A novel scoring system for stroke risk stratification in Japanese patients with low CHADS2 scores: Study using a transesophageal‐echocardiogram endpoint.

摘要

Atrial fibrillation (AF) has a relation with a risk of thromboembolic events. Of intracardiac thrombi in patients with AF, approximately 90% is located in the left atrial appendage (LAA). Transesophageal echocardiography (TEE) is considered the gold standard for identification of LAA thrombi. Sensitivity is about 95% and specificity is 100% and is widely used in clinical practice to screen for the presence of LAA thrombi in patients with AF. Recent studies reported the prevalence of LAA thrombi in Japanese nonvalvular atrial fibrillation (NVAF) patients on anticoagulation therapy undergoing preprocedural TEE. , Kawabata et al described that the prevalence of LAA thrombus in anti‐coagulated Japanese NVAF patients undergoing preprocedural TEE was 2.7%, and this was similar between the warfarin and the DOAC groups. No LAA thrombus was identified in patients with CHA DS VASc score = 0, or AF patients without a prior stroke. BNP ≥173 pg/mL was the only independent predictor of LAA thrombus.