What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Non-valvular atrial fibrillation (n=525). Intervention: Systemic immune-inflammatory index (SII) >750 vs. Systemic immune-inflammatory index (SII) ≤750. Primary outcome: Left atrial appendage (LAA) thrombus (HR 4.291, 95% CI 2.144-8.586, p=<0.001).

February 9, 2023Open Access

The predictive value of the systemic immune-inflammatory index for left atrial appendage thrombus in non-valvular atrial fibrillation

Q: What are the key findings of this study?

A systemic immune-inflammatory index >750 independently predicted left atrial appendage thrombus in patients with non-valvular atrial fibrillation (HR 4.291).

Key Result

A systemic immune-inflammatory index >750 independently predicted left atrial appendage thrombus in patients with non-valvular atrial fibrillation (HR 4.291).

Study Design

Type

Cross-Sectional (n=525)

Multicenter

Structured PICO

Does the systemic immune-inflammatory index (SII) predict left atrial appendage thrombus in patients with non-valvular atrial fibrillation?

Population

525 patients newly diagnosed with non-valvular atrial fibrillation, who had not previously had anticoagulant treatment, planned to undergo medical or electrical cardioversion (50.7% male, mean age 62.9 ± 10.8 years).

Intervention

Systemic immune-inflammatory index (SII) measurement

Outcome

Presence of left atrial appendage (LAA) thrombus detected by transesophageal echocardiographysurrogate

The systemic immune-inflammatory index (SII) is an independent predictor of left atrial appendage thrombus in patients with non-valvular atrial fibrillation, which may help guide anticoagulation decisions.

Main Result

Effect estimate: HR 4.291 (95% CI 2.144-8.586)

p-value: p=<0.001

Limitations

Single-centre study with a limited number of patients
Duration and medication for diabetes were not assessed
Other parameters such as LAA anatomy were not investigated

Abstract

OBJECTIVE: The systemic immune inflammatory index (SII) has prognostic value in cardiovascular diseases. The aim of current study was to investigate whether or not left atrial appendage (LAA) thrombus could be predicted by SII in patients with non-valvular atrial fibrillation. METHOD: The study included 525 patients newly diagnosed with non-valvular atrial fibrillation, who had not previously had anticoagulant treatment (50.7% male, mean age 62.94±10.79 years). All patients underwent transoesophageal echocardiography. RESULTS: LAA thrombus was observed in 86 patients (16.4%). In the ROC curve SII had a good diagnostic power in predicting LAA thrombus (AUC: 0.760, 95% CI: 0.703-0.818, P750 (Hazard ratio: 4.291, 95% CI: 2.144-8.586 P<0.001) were determined as independent predictors for LAA thrombus. A poor correlation was found between SII and the CHADS2 VASc score (r=0.239, P<0.001) Conclusion. The SII, a practical and easily obtained test, can be used as a predictor of LAA thrombus in patients with non-valvular atrial fibrillation, and to decide on the anticoagulant treatment.

Mark Helpful

Bookmark

Relay

View Full Paper