Key result
Higher RCII linked to ~23% higher risk of left atrial thrombus or SEC in low-risk AF.
Why the study?
Left atrial thrombus is the main cause of ischemic stroke in AF, and this study aimed to evaluate NVAF patients with TEE-confirmed LAT/SEC compared to those without using the residual cholesterol inflammatory index as a biomarker.
Does the residual cholesterol inflammatory index (RCII) combined with left atrial diameter predict left atrial thrombus or spontaneous echo contrast in patients with nonvalvular atrial fibrillation and low CHA2DS2-VASc scores?
Cohort (n=967)
No
Does the residual cholesterol inflammatory index (RCII) combined with left atrial diameter predict left atrial thrombus or spontaneous echo contrast in patients with nonvalvular atrial fibrillation and low CHA2DS2-VASc scores?
Odds Ratio: 1.232 (95% CI 1.159–1.309)
p-value: p=<0.001
May refine LA thrombus risk stratification in low CHA2DS2-VASc NVAF; hypothesis-generating and requires prospective validation before clinical adoption.
Background: Left atrial thrombus (LAT) is the main cause of ischemic stroke in patients with atrial fibrillation. Left atrial thrombus or spontaneous echo contrast (SEC) can be best displayed by transesophageal echocardiography (TEE). This study aimed to evaluate non-valvular atrial fibrillation (NVAF) patients with LAT/SEC confirmed by transesophageal echocardiography compared with those without LAT/SEC, using residual cholesterol inflammatory index (RCII) as a sensitive biomarker. Methods: This study was a retrospective study of 967 NVAF patients who underwent transesophageal echocardiography at a single center. Patients were divided into two groups based on the presence or absence of LAT/SEC on TEE. The levels of RCII and left atrium diameter (LAD) were compared. Conclusion: Our study demonstrates that RCII and LAD are risk factors for LAT/SEC. CHA2DS2-VASc score combined with RCII and LAD can significantly improve the predictive ability of LAT/SEC.
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Wang et al. (2026) conducted a cohort in Non-valvular atrial fibrillation (NVAF) with low CHA2DS2-VASc scores (n=967). Residual cholesterol inflammatory index (RCII) vs. Lower RCII levels was evaluated on Left atrial thrombus (LAT) or spontaneous echo contrast (SEC) (OR 1.232, 95% CI 1.159-1.309, p=<0.001). Higher residual cholesterol inflammatory index (RCII) was independently associated with an increased risk of left atrial thrombus or spontaneous echo contrast in patients with non-valvular atrial fibrillation and low CHA2DS2-VASc scores (OR 1.232).
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