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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Risk factors for left atrial appendage thrombus

Kerem Can Yilmaz1, Arzu Neslihan Akgun1, Orcun Ciftci1

  • 1Cardiology Department, Baskent University School of Medicine, Ankara, Turkey.

Acta Cardiologica
|April 29, 2020
PubMed

Insights

The CHA2DS2-VASc score did not predict left atrial appendage thrombi in atrial fibrillation patients. Independent predictors for thrombus formation were atrial fibrillation and coronary artery disease.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Thrombosis Research

Background:

  • Atrial fibrillation (AF) significantly increases stroke risk, with left atrial appendage (LAA) thrombi being a primary cause of cardioembolic strokes.
  • The CHA2DS2-VASc score is used to guide anticoagulation decisions in nonvalvular AF.
  • Identifying factors for LAA thrombus formation is crucial for stroke prevention.

Purpose of the Study:

  • To evaluate the predictive value of the CHA2DS2-VASc score for LAA thrombus formation.
  • To investigate other risk factors, echocardiographic data, and blood parameters associated with LAA thrombi.

Main Methods:

  • Retrospective analysis of 264 adult cardiology outpatients undergoing transesophageal echocardiography between June 2017 and June 2019.
  • Data collected included demographic information, transthoracic echocardiographic findings, and laboratory results.

Main Results:

  • LAA thrombus was identified in 14.7% of patients.
  • Coronary artery disease and systolic dysfunction were more prevalent in patients with LAA thrombi (p=0.017, p=0.016).
  • Thrombus rates were higher in persistent AF (51%) compared to other subtypes (25.7%, p=0.002). The CHA2DS2-VASc score showed no significant difference between groups.

Conclusions:

  • The CHA2DS2-VASc score alone is not a reliable indicator for LAA thrombus formation.
  • Atrial fibrillation and coronary artery disease are independent determinants of LAA thrombus.
  • Further research into specific risk factors beyond the CHA2DS2-VASc score is warranted for LAA thrombus prediction.

Keywords:
Atrial fibillationCHA2DS2-VASc score

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