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Risk factors for left atrial appendage thrombus.

Authors :: Yilmaz KC
Akgun AN
Ciftci O
Eroglu S
Pirat B
Sade E
Ulucam M
Ozin B
Muderrisoglu H
Source :: Acta cardiologica [Acta Cardiol] 2020 Aug; Vol. 75 (4), pp. 355-359. Date of Electronic Publication: 2020 Apr 28.
Publication Year :: 2020
Abstract: 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. CHA <subscript>2</subscript> DS <subscript>2</subscript> -VASc is a risk scoring system to identify patients' indications for anticoagulation in nonvalvular AF patients. The aim of our study was to investigate CHA <subscript>2</subscript> DS <subscript>2</subscript> -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 CHA <subscript>2</subscript> DS <subscript>2</subscript> -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, CHA <subscript>2</subscript> DS <subscript>2</subscript> -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.