Elevated serum lipoprotein(a) is a risk factor for left atrial thrombus in patients with chronic 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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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

Y Igarashi1, M Yamaura, M Ito

  • 1Division of Cardiology, Department of Medicine, Tsuruoka City Shonai Hospital, and The First Department of Internal Medicine, Niigata University School of Medicine, Tsuruoka, Yamagata, Japan.

American Heart Journal
|December 8, 1998
PubMed

Insights

Elevated lipoprotein(a) [Lp(a)] levels are a significant risk factor for left atrial thrombus in patients with chronic atrial fibrillation. This finding suggests Lp(a) may be a novel predictor for thrombus formation in this population.

Area of Science:

  • Cardiology
  • Thrombosis Research
  • Lipid Metabolism

Background:

  • Chronic atrial fibrillation increases the risk of thromboembolism.
  • Lipoprotein(a) [Lp(a)], with structural similarity to plasminogen, may influence thrombotic events by affecting the fibrinolytic system.
  • The specific role of Lp(a) in left atrial thrombus formation remains understudied.

Purpose of the Study:

  • To investigate whether Lp(a) levels are associated with the presence of left atrial thrombus in patients with chronic atrial fibrillation.
  • To determine if Lp(a) is a risk factor for left atrial thrombus formation.

Main Methods:

  • Prospective collection of clinical, biochemical, and echocardiographic data from 150 patients with chronic atrial fibrillation.
  • Diagnosis of left atrial thrombus using transesophageal echocardiography.
  • Statistical analysis including univariate and multivariate regression to identify predictors of left atrial thrombus.

Main Results:

  • Left atrial thrombus was identified in 19% of patients (n=29).
  • Patients with left atrial thrombus exhibited higher Lp(a) concentrations (34.5 vs 17.9 mg/dL, P<.0001), increased spontaneous echo contrast (93% vs 55%, P<.0001), larger left atria (5.4 vs 4.8 cm, P<.001), and lower left atrial appendage peak flow velocity (11.1 vs 23.5 cm/s, P<.0001).
  • Multivariate analysis confirmed Lp(a) concentration as a significant positive predictor (P<.0001) and left atrial appendage peak flow velocity as a negative predictor (P=.0125).

Conclusions:

  • Elevated serum Lp(a) levels are strongly linked to the presence of left atrial thrombus.
  • Lp(a) may represent a novel risk factor for left atrial thrombus in individuals with chronic atrial fibrillation.
Abstract

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