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Left Atrial Appendage Thrombus Detected During Hyperacute Stroke Imaging Is Associated With Atrial Fibrillation
Sajith C Senadeera1, David G Palmer2, Ross Keenan1
1Department of Radiology (S.C.S., R.K., M.A.H., P.M., A.L.), Christchurch Hospital, New Zealand.
Stroke
|November 9, 2020
Summary
Left atrial appendage (LAA) thrombus is common in atrial fibrillation (AF) patients and can be detected on hyperacute stroke imaging. This finding suggests LAA thrombus may serve as a radiological marker for AF.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Left atrial appendage (LAA) thrombus is a primary source of emboli in cardioembolic strokes related to atrial fibrillation (AF).
- Identifying LAA thrombus in hyperacute stroke imaging is crucial for understanding stroke etiology.
Purpose of the Study:
- To determine the prevalence of LAA thrombus in patients undergoing hyperacute stroke imaging.
- To investigate the association between LAA thrombus and atrial fibrillation (AF).
Main Methods:
- Retrospective analysis of 303 patients within a 12-month hyperacute stroke imaging pathway.
- LAA thrombus assessment by two blinded radiological readers on computed tomography angiogram.
- Multivariable logistic regression to determine the association between AF and LAA thrombus.
Main Results:
- Overall LAA thrombus prevalence was 6.6%, rising to 14.9% in patients with known AF.
- LAA thrombus was associated with older age, heart failure, and intracranial large vessel occlusion.
- Atrial fibrillation (AF) was independently associated with LAA thrombus (OR, 3.71; P=0.02) after adjusting for age and heart failure.
Conclusions:
- Left atrial appendage (LAA) thrombus can be detected using hyperacute stroke imaging protocols.
- LAA thrombus may serve as a valuable radiological marker for identifying atrial fibrillation (AF).
