AIM  To analyze the risk factors for thromboembolism and the predictive value of thromboembolism events in valvular atrial fibrillation (AF) patients.

  METHODS  A total of 137 valvular atrial fibrillation patients who were admitted to our hospital between September 2016 and September 2019 were included in this study. The patients were divided into group of patients with thromboembolism (study group, n=50) and group of patients without thromboembolism (control group, n=87). On the basis of univariate analysis, multivariate logistic regression analysis was conducted to explore the risk factors for thromboembolism and Cochran-Armitage trend test was conducted to explore whether there was a linear trend between CHA2DS2-VASc and the rates of thromboembolism. ROC curve was used to determine the area and cutoff point under it, and the corresponding evaluation indexes were calculated.

  RESULTS  The proportion of patients aged ≥ 75 years and of female patients, and the prevalence of hypertension, diabetes and heart failure in the study group were not significantly different from those in the control group, but the prevalence of vascular disease and the CHA2DS2-VASC score were both significantly different between the two groups (P<0.01). After regression analysis, vascular disease (OR:7.463, 95%CI:1.575-35.714, P<0.05) was an independent risk factor for thromboembolism. After controlling for other variables, CHA2DS2-VASC score was significantly associated with the prevalence of thromboembolism events (OR: 2.688, 95%CI: 1.776-4.065, P<0.01) and the area under ROC curve for prediction of embolism events was 0.869 (95%CI :0.809-0.928, P<0.01). The Cochran-Armitage test showed a linear trend between CHA2DS2-VASc and the rates of thromboembolism events, and the incidence of thromboembolism events increased with the increase of CHA2DS2-VASc (P<0.01).

  CONCLUSIONS  Vascular disease is an independent risk factor for the prevalence of stroke/transient ischemic attack/thromboembolism events in valvular AF patients. The CHA2DS2-VASC score is significantly associated with the prevalence of stroke/transient ischemic attack/thromboembolism events and has a good predictive value, and the incidence of stroke/transient ischemic attack/thromboembolism increases with the increase of CHA2DS2-VASc.