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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.

Journal of Thrombosis and Thrombolysis
|November 28, 2023
PubMed

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.

Keywords:
AngioscopyAortic thrombiAtrial fibrillationNOGA

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