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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

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New perspective on the risk markers for left atrial thrombosis in patients with atrial fibrillation

Xuan Zhang1, Mengjie Hu2, Xiying Wang1

  • 1Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

European Journal of Preventive Cardiology
|February 21, 2021
PubMed

Insights

Abnormal uric acid metabolism (abUA) is an independent risk marker for left atrial thrombosis (LAT) in atrial fibrillation patients. Incorporating abUA into the CHA2DS2-VASc score improves its accuracy for predicting LAT.

Area of Science:

  • Cardiology
  • Thrombosis Research
  • Medical Risk Assessment

Background:

  • Anticoagulant therapy is crucial for managing atrial fibrillation (AF) and preventing embolic events.
  • The CHA2DS2-VASc score aids in assessing embolic risk but may not capture all LAT formation factors.
  • Emerging evidence suggests markers beyond the CHA2DS2-VASc score influence left atrial thrombosis (LAT).

Purpose of the Study:

  • To identify novel risk markers for LAT in patients with AF.
  • To evaluate the predictive value of these markers beyond the existing CHA2DS2-VASc score.
  • To enhance the accuracy of LAT risk stratification in AF management.

Main Methods:

  • Retrospective analysis of 2246 AF patients undergoing transesophageal echocardiography.
  • Binary logistic regression and propensity score matching (PSM) to identify independent risk markers.
  • Receiver operating characteristic (ROC) analysis to assess the improved predictive ability of an enhanced risk score.

Main Results:

  • Abnormal uric acid metabolism (abUA) and obesity were identified as risk markers for LAT.
  • PSM confirmed abUA as an independent risk marker for LAT.
  • Including abUA in the CHA2DS2-VASc score significantly improved its accuracy for predicting LAT (AUC difference 0.0651, P=0.0016).

Conclusions:

  • Abnormal uric acid metabolism (abUA) is a significant independent risk marker for left atrial thrombosis (LAT).
  • Integrating abUA into the CHA2DS2-VASc score enhances its predictive accuracy for LAT in AF patients.
Abstract

Keywords:
Atrial fibrillationrisk markerthrombosisuric acid

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