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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
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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
Summary
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.
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