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Body mass index and risk of left atrial thrombus in patients with atrial fibrillation

Ri-Bo Tang1, Xiao-Hui Liu, Jérôme Kalifa

  • 1Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China.

The American Journal of Cardiology
|December 8, 2009
PubMed

Insights

Elevated body mass index (BMI) significantly increases the risk of left atrial/left atrial appendage thrombus in patients with atrial fibrillation (AF). A BMI of 27.0 kg/m² or higher is an independent risk factor for thrombus formation.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Medical Research

Background:

  • Atrial fibrillation (AF) is a common arrhythmia associated with an increased risk of thromboembolic events.
  • Left atrial (LA) and left atrial appendage (LAA) thrombus formation is a major concern in AF patients, particularly before catheter ablation.
  • The role of body mass index (BMI) as a risk factor for LA/LAA thrombus in AF patients requires further elucidation.

Purpose of the Study:

  • To investigate the association between body mass index (BMI) and the presence of left atrial/left atrial appendage (LA/LAA) thrombus.
  • To determine if elevated BMI is an independent risk factor for LA/LAA thrombus in patients with nonvalvular atrial fibrillation (AF) undergoing evaluation for catheter ablation.

Main Methods:

  • A cohort of 433 consecutive patients with nonvalvular AF were enrolled between January 2007 and March 2008.
  • Transesophageal echocardiography was performed to assess for LA/LAA thrombus.
  • Statistical analyses, including multivariable logistic regression, were used to identify independent risk factors for thrombus.

Main Results:

  • Twenty-six out of 433 patients (6.0%) were found to have LA/LAA thrombus.
  • Patients with thrombus had a significantly higher mean BMI (27.9 ± 3.1 kg/m²) compared to those without thrombus (26.0 ± 3.3 kg/m²).
  • A BMI ≥ 27.0 kg/m² was associated with a higher incidence of LA/LAA thrombus (10.6% vs 3.0%) and identified as an independent risk factor (OR 4.02, 95% CI 1.19-13.55).

Conclusions:

  • Body mass index (BMI) ≥ 27.0 kg/m² is an independent risk factor for the development of LA/LAA thrombus in patients with atrial fibrillation (AF).
  • These findings highlight the importance of weight management in reducing thromboembolic risk in AF patients.
  • BMI should be considered in the risk stratification of AF patients undergoing procedures like catheter ablation.

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