Risk factors for left atrial thrombus or spontaneous echo contrast in non-valvular atrial fibrillation patients with low CHA 2 DS 2 -VASc score
Risk factors of left atrial thrombus (LAT) or spontaneous echo contrast (LASEC) in non-valvular atrial fibrillation (NVAF) had been reported. However, information in the subgroup of NVAF patients with low CHA DS -VASc scores was limited. Here, we evaluated the risk factors of LAT/LASEC in NVAF patie...
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Published in | Journal of thrombosis and thrombolysis Vol. 53; no. 2; p. 523 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Netherlands
01.02.2022
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Subjects | |
Online Access | Get full text |
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Summary: | Risk factors of left atrial thrombus (LAT) or spontaneous echo contrast (LASEC) in non-valvular atrial fibrillation (NVAF) had been reported. However, information in the subgroup of NVAF patients with low CHA
DS
-VASc scores was limited. Here, we evaluated the risk factors of LAT/LASEC in NVAF patients with low CHA
DS
-VASc scores.
Transesophageal echocardiography (TEE) file of NVAF patients with low CHA
DS
-VASc scores was reviewed (between June 2009 and Feb 2019) in this retrospective observational study. Binary logistic regression analysis was performed to identify risk factors other than the CHA
DS
-VASc score. Propensity score matching (PSM) was used to further evaluate independent risk markers for LAT/LASEC. The newly discovered factors were added to the CHA
DS
-VASc score, and receiver operating characteristic analysis was used to evaluate the ability of the model to predict LAT/LASEC.
TEE files of 3056 NVAF patients with low CHA
DS
-VASc scores were reviewed. Regression analysis revealed elevated fibrinogen and enlarged left atrium (LA) were risk factors for LAT/LASEC. Further PSM analysis confirmed that elevated fibrinogen and enlarged LA were independent risk factors for LAT/LASEC. After including fibrinogen and left atrial diameter (LAD), the CHA
DS
-VASc score was more accurate for LAT/LASEC prediction in NVAF patients with low CHA
DS
-VASc scores (area under the curve difference is 0.241, 95% confidence interval (CI) 0.188-0.294, Z = 8.890, P < 0.0001).
Elevated fibrinogen and enlarged LA were independent risk factors for LAT/LASEC in NVAF patients with low CHA
DS
-VASc scores. Taking fibrinogen and LAD into consideration may help improve LAT/LASEC risk evaluation, which warrants further validation studies. |
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ISSN: | 1573-742X |