Role of the CHADS(2) Score in the Evaluation of Carotid Atherosclerosis in Patients with Atrial Fibrillation Undergoing Carotid Artery Ultrasonography

OBJECTIVE: This study investigated the characteristics of carotid atherosclerosis in patients with atrial fibrillation (AF) and determined the feasibility and significance of the CHADS(2) score in predicting the degree of carotid atherosclerosis. METHODS: Consecutive patients (n = 109) with nonvalvular AF were registered and classified into two groups, the paroxysmal AF group (n = 59) and persistent AF group (n = 50). Fifty healthy patients, matched by sex and age, were considered the control group. All patients were examined using carotid ultrasound and velocity vector imaging (VVI). RESULTS: Compared with the control group, the mean intimal-medial thickness in the paroxysmal AF group (0.56 ± 0.11 versus 0.61 ± 0.10, respectively, P < 0.05) and the persistent AF group (0.56 ± 0.11 versus 0.64 ± 0.13, respectively, P < 0.001) was significantly increased. The plaque index (PI) in the persistent AF group was significantly higher than that observed in the paroxysmal AF group (1.05 ± 1.33 versus 1.42 ± 1.47, respectively, P < 0.001). Regarding the VVI indices, those reflecting the long-axis longitudinal motion function of carotid arteries were significantly decreased in both AF groups. Compared with the control group, a significantly lower total longitudinal displacement (tLoD) index was observed in the persistent AF group (0.73 ± 0.66 versus 0.31 ± 0.23, respectively, P < 0·0001) and the paroxysmal AF group (0.73 ± 0.66 versus 0.34 ± 0.17, P < 0·0001). The CHADS(2) score was related to indicators reflecting the structure and function of the carotid artery. CONCLUSIONS: Carotid arterial structure and function were significantly altered in patients with AF. The degree of carotid atherosclerosis depended on the duration of AF. The CHADS(2) score may be useful as a predictor of the extent of carotid atherosclerosis in patients with AF.