Key result
Higher C-reactive protein-albumin ratio is linked to ~2.7-fold higher odds of left atrial thrombosis.
Why the study?
Although inflammation markers are known prognostic tools in acute ischemic stroke, their comparative ability to predict left atrial thrombosis in ischemic stroke patients without AF needed evaluation.
Do systemic inflammation scores predict the presence of left atrial thrombosis in patients with acute ischemic stroke without atrial fibrillation?
Cohort (n=303)
No
Do systemic inflammation scores predict the presence of left atrial thrombosis in patients with acute ischemic stroke without atrial fibrillation?
The C-reactive Protein-to-Albumin Ratio (CAR) is an independent, readily accessible predictor of left atrial thrombosis in acute ischemic stroke patients without atrial fibrillation, aiding in risk stratification for semi-invasive TEE screening.
May inform targeted TEE screening in non-AF stroke; hypothesis-generating and requires prospective validation before adoption.
Background and Objectives: Studies have shown that inflammation markers can be used as prognostic tools in predicting acute ischemic stroke. In this study, we conducted a comparison of several inflammation scores in predicting left atrial thrombosis (LAT) in patients with ischemic stroke without AF. Materials and Methods: In this single-center, retrospective study, we included 303 consecutive patients with ischemic stroke. Each patient underwent a transesophageal echocardiography (TEE) examination within 10 days of admission to detect the presence of LAT. To identify independent predictors of LAT, we conducted a multivariate logistic regression analysis. Results: In total, 303 patients who had ischemic stroke were included in the analysis. LAT was detached in 34 patients at the time of the TEE examination. The patients were categorized into two groups based on their LAT status. The Prognostic Nutritional Index (PNI), HALP score, and C-reactive Protein–Albumin Ratio (CAR) were identified as statistically significant predictors of LAT. Based on the results of the multivariate regression analysis, the CAR emerged as the only independent predictor of LAT. Conclusions: Among several inflammation scores, the PNI, HALP, and CAR were statistically significant predictors of LAT in ischemic stroke patients without AF. CAR was identified as the optimal score for the prediction of LAT in patients with stroke and without AF.
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Çiçek et al. (2024) conducted a cohort in Acute ischemic stroke without atrial fibrillation (n=303). C-reactive Protein-Albumin Ratio (CAR) vs. Lower CAR scores and other inflammatory markers was evaluated on Presence of left atrial thrombosis (LAT) (OR 2.7001, 95% CI 1.3874-5.2547, p=0.003). The C-reactive Protein-Albumin Ratio (CAR) independently predicted the presence of left atrial thrombosis in patients with acute ischemic stroke without atrial fibrillation (OR 2.7001).
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