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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Association between aortic thrombi detected using non-obstructive general angioscopy and atrial fibrillation
Saki Mizobuchi1, Keisuke Kojima2, Masatsugu Miyagawa1
1Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
Insights
Atrial fibrillation (AF) significantly increases the risk of aortic thrombi in patients with coronary artery disease. Non-obstructive general angioscopy (NOGA) revealed a higher prevalence of these thrombi in AF patients, suggesting a link between AF and aortic clot formation.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Atrial fibrillation (AF) is a known risk factor for stroke and systemic embolism.
- Aortic thrombi and atherosclerotic plaques are potential sources of emboli.
- Non-obstructive general angioscopy (NOGA) visualizes aortic intimal findings, but its utility in AF patients is understudied.
Purpose of the Study:
- To investigate aortic intimal findings using NOGA in patients with and without AF.
- To evaluate the association between AF and the presence of aortic thrombi detected by NOGA.
Main Methods:
- A cohort of 283 consecutive patients with coronary artery disease undergoing aortic NOGA between 2017 and 2022 was analyzed.
- Patients were stratified into AF (n=50) and non-AF (n=233) groups.
- NOGA identified aortic intimal findings, including thrombi and plaques, with statistical analysis comparing the groups.
Main Results:
- Aortic thrombi were significantly more frequent in the AF group (92.0%) compared to the non-AF group (71.6%, p < 0.001).
- No significant differences were observed in intense yellow or ruptured plaques between the groups.
- Multivariate analysis confirmed AF as an independent predictor of aortic thrombi (OR 3.87, p = 0.016).
Conclusions:
- The presence of aortic thrombi, as detected by NOGA, is significantly associated with atrial fibrillation in patients with coronary artery disease.
- These findings highlight a potential link between AF and aortic thrombus formation, warranting further investigation into their role in embolic events.
Abstract:
Atrial fibrillation (AF) is an independent risk factor for stroke and systemic embolism. Cardiogenic and aortogenic emboli are causes of stroke or systemic embolism. Non-obstructive general angioscopy (NOGA) can be used to diagnose aortic intimal findings, including thrombi and atherosclerotic plaques, but little is known about NOGA-derived aortic intimal findings in patients with AF. This study focused on aortic intimal findings in patients with AF and evaluated the association between AF and aortic thrombi detected using NOGA. We enrolled 283 consecutive patients with coronary artery disease who underwent NOGA of the aorta between January 2017 and August 2022. Aortic intimal findings were screened using NOGA after coronary arteriography. The patients were divided into two groups according to their AF history (AF, n = 50 and non-AF, n = 233). Patients in the AF group were older than those in the non-AF group. Sex, body mass index, and coronary risk factors were not significantly different between the two groups. In the NOGA findings, the presence of intense yellow plaques and ruptured plaques was not significantly different between the two groups. Aortic thrombi were more frequent in the AF group than in the non-AF group (92.0 vs. 71.6%, p < 0.001). Multivariate logistic regression found that AF was independently associated with aortic thrombi (odds ratio 3.87 [95% CI 1.28-11.6], p = 0.016). The presence of aortic thrombi observed using NOGA was associated with AF in patients with coronary artery disease. The roles of aortic thrombi as well as cardiogenic embolism may require clarification.
