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July 18, 2026Cardiovascular TherapeuticsOpen Access

Development and Validation of a Nomogram for Estimating Stroke Risk in Nonvalvular Atrial Fibrillation Patients With Left Atrial Stiffness: A Single‐Center Cross‐Sectional Study

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Why the study?

Does a nomogram incorporating LA stiffness and clinical factors improve stroke risk estimation compared to the CHA2DS2-VASc score in patients with nonvalvular atrial fibrillation?

Population

402 consecutive patients with nonvalvular atrial fibrillation (NVAF)

Comparison

Nomogram incorporating echocardiographic left… vs CHA2DS2-VASc model

Design

Cross-sectional, Patients were randomly assigned to training and validation…

Key result

A nomogram incorporating left atrial stiffness and clinical factors showed excellent discrimination for stroke risk in NVAF patients, with a C-statistic of 0.880 (95% CI 0.808-0.932) in validation.

Authors

DZDecai ZengXCXiangling CaoYCYongzhi Cai

Discussion

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Member takes

Overview

May refine NVAF stroke risk estimates with LA stiffness; leaves open prospective validation before clinical adoption.

Key Points

  • This study aims to assess the significance of left atrial stiffness and develop a nomogram for estimating stroke risk in nonvalvular atrial fibrillation patients.
  • Enrolled 402 consecutive NVAF patients
  • Randomly assigned to training (n=281) and validation (n=121) cohorts
  • Used logistic regression to identify stroke risk factors and constructed a nomogram.
  • Identified independent factors: LA stiffness, LA reservoir strain, hypertension, peripheral vascular disease, and anticoagulation.
  • Nomogram showed excellent discrimination with C-statistics of 0.889 in training and 0.880 in validation cohorts.
  • Model with anticoagulation outperformed CHA2DS2-VASc model, indicating better stroke risk assessment.

Study Design

Type

Cross-Sectional (n=402)

Multicenter

No

Structured PICO

Does a nomogram incorporating LA stiffness and clinical factors improve stroke risk estimation compared to the CHA2DS2-VASc score in patients with nonvalvular atrial fibrillation?

P
Population
402 consecutive patients with nonvalvular atrial fibrillation evaluated to develop and validate a stroke risk nomogram.
E
Exposure
Nomogram incorporating echocardiographic left atrial (LA) stiffness, LA reservoir strain, hypertension, peripheral vascular disease, and anticoagulation
C
Comparator
CHA2DS2-VASc model
O
Outcome
Stroke risk estimation (model discrimination and reclassification)

Main Result

Effect estimate: C-statistic 0.880 (95% CI 0.808-0.932)

A novel nomogram incorporating echocardiographic left atrial stiffness and clinical factors provides superior stroke risk estimation in NVAF patients compared to the standard CHA2DS2-VASc score.

Limitations

  • Requires prospective validation

Cite This Study

Zeng et al. (2026) conducted a cross-sectional in Nonvalvular atrial fibrillation (n=402). Nomogram incorporating LA stiffness and clinical parameters vs. CHA2DS2-VASc model was evaluated on Stroke risk discrimination (C-statistic 0.880, 95% CI 0.808-0.932). A nomogram incorporating left atrial stiffness and clinical factors showed excellent discrimination for stroke risk in NVAF patients, with a C-statistic of 0.880 (95% CI 0.808-0.932) in validation.

synapsesocial.com/papers/6a5b38f68167787360d24e09https://doi.org/10.1155/cdr/8877050
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