Journal of Thrombosis and Thrombolysis

, Volume 45, Issue 4, pp 571–577 | Cite as

The predictive value of the CHA2DS2-VASc score in patients with mechanical mitral valve thrombosis

  • Tufan Çınar
  • Mert Ilker Hayıroğlu
  • Veysel Ozan Tanık
  • Emre Aruğaslan
  • Muhammed Keskin
  • Mahmut Uluganyan
  • Ahmet Öz
  • Metin Çağdaş
  • Ahmet Taha Alper


Prosthetic valve thrombosis (PVT) is a potentially life-threatening complication associated with high morbidity and mortality. The CHA2DS2-VASc is a clinical score used to determine thromboembolism risk in non-valvular atrial fibrillation patients. Therefore; in this study, we aimed to determine predictive value of the CHA2DS2-VASc score for development of PVT in patients with mechanical prosthetic valve. This was a retrospective study included 417 consecutive patients with mechanic prosthetic valve in whom transesophageal echocardiography (TEE) was performed due to different clinical indications from January 2004 to June 2016. After evaluation according to exclusion criteria, 267 patients with mechanic prosthetic valve were enrolled in the study. The definitive diagnosis of the PVT was made as proposed by TEE finding. The study population was divided into two groups; PVT patients (154 patients) and control group (113 patients) with functional prosthetic valve. The CHA2DS2-VASc score was calculated for each patient from the hospital electronic database. The mechanical mitral valve thrombosis predictive value of variables including CHA2DS2-VASc score was tested in our study. The mean CHA2DS2-VASc score was significantly higher in PVT patients compared to control patients (2.51 ± 1.54 vs. 1.13 ± 1.21, p < 0.01). Both on univariate and multivariate analysis demonstrated that the CHA2DS2-VASc score is independently associated with PVT (p < 0.001 and p < 0.001, respectively). The patients whose CHA2DS2-VASc score ≥ 1–3 had 6.20 times higher risk for thrombus formation, and patients whose CHA2DS2-VASc score ≥ 4 had 16.6 times higher risk for thrombus formation compared to patients with CHA2DS2-VASc score = 0 (p < 0.001 and p < 0.001, respectively). The CHA2DS2-VASc score may be a significant independent predictor of PVT in patients with prosthetic valve and the CHA2DS2-VASc score ≥ 2.5 or more was associated with increased PVT in patients with prosthetic valve. Thus; it may be an applicable risk scoring system to assess the risk of development of PVT in patients with prosthetic valve.


Prosthetic valve thrombosis CHA2DS2-VASc score Mitral valve 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research involving human and animal participants

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained just to perform the TEE procedure.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Tufan Çınar
    • 1
  • Mert Ilker Hayıroğlu
    • 1
  • Veysel Ozan Tanık
    • 2
  • Emre Aruğaslan
    • 3
  • Muhammed Keskin
    • 1
  • Mahmut Uluganyan
    • 4
  • Ahmet Öz
    • 1
  • Metin Çağdaş
    • 5
  • Ahmet Taha Alper
    • 6
  1. 1.Department of Cardiology, Sultan Abdülhamid Han Training and Research HospitalHealth Sciences UniversityIstanbulTurkey
  2. 2.Department of CardiologyAnkara Dışkapı Yıldırım Beyazıt Training and Research HospitalAnkaraTurkey
  3. 3.Department of CardiologySivas Numune HospitalSivasTurkey
  4. 4.Department of CardiologyBezmialem UniversityIstanbulTurkey
  5. 5.Department of CardiologyKafkas UniversityIstanbulTurkey
  6. 6.Department of Cardiology, Siyami Ersek Training and Research HospitalHealth Sciences UniversityIstanbulTurkey

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