Key result
Persistent atrial fibrillation was associated with a significantly higher rate of left atrial appendage thrombus compared to other subtypes (51% vs 25.7%, p=0.002).
Why the study?
The study aimed to investigate the CHA2DS2-VASc score, other risk factors, echocardiographic data, and blood parameters for left atrial appendage thrombus.
Observational (n=264)
No
Absolute Event Rate: 51% vs 25.7%
p-value: p=0.002
The CHA2DS2-VASc score alone may not be sufficiently informative for predicting LAA thrombus formation, which is more strongly associated with the presence of AF and coronary artery disease.
CHA2DS2-VASc may inadequately predict LAA thrombus; leaves open whether AF and CAD warrant refined risk models in observational cohorts.
Background: Atrial fibrillation (AF) is the most common persistent rhythm disorder that has been shown to be associated with a significant increase in stroke risk. Left atrial appendage (LAA) thrombi are responsible for most of strokes of cardiac origin. CHA2DS2-VASc is a risk scoring system to identify patients’ indications for anticoagulation in nonvalvular AF patients. The aim of our study was to investigate CHA2DS2-VASc score, the other risk factors, echocardiographic data and blood parameters for LAA thrombus.Methods: Two hundred and sixty-four patients who were admitted to our adult cardiology outpatient clinic and who underwent a transesophageal echocardiography procedure between June 2017 and June 2019 included in our study. Patient’s demographic data, transthoracic echocardiographic examinations, and laboratory results were recorded retrospectively.Results: LAA thrombus was detected in 39 (14.7%) patients. The rates of coronary artery disease and systolic dysfunction were significantly higher in patients with LAA thrombus (p = .017, p = .016, respectively). When AF subtypes were examined in detail, thrombus rate was significantly higher in persistent AF (51 vs. 25.7%, p = .002). Although the CHA2DS2-VASc score was slightly higher in the thrombus group, there was no statistically significant difference between the two groups (3.0 ± 1.65 vs. 2.78 ± 1.66).Conclusions: In conclusion, CHA2DS2-VASc score system itself was not informative about LAA thrombus formation although some of its components were related with LAA thrombus formation. According to a multiple regression analysis, the independent determinants of LAA thrombus were the presence of AF and coronary artery disease.
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Yılmaz et al. (2020) conducted an observational in Atrial fibrillation (n=264). Persistent atrial fibrillation vs. Non-persistent atrial fibrillation was evaluated on Left atrial appendage thrombus (p=0.002). Persistent atrial fibrillation was associated with a significantly higher rate of left atrial appendage thrombus compared to other subtypes (51% vs 25.7%, p=0.002).
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