Among patients with nonvalvular atrial fibrillation and low CHA2DS2-VASc scores, female sex (OR 4.612) and left atrial diameter ≥45 mm (OR 13.340) were independently associated with LAA thrombus.
Observational (n=919)
No
In patients with nonvalvular atrial fibrillation and low CHA2DS2-VASc scores, female sex and left atrial diameter ≥ 45 mm are independent risk factors for left atrial appendage thrombus or sludge.
Effect estimate: OR 13.340 (95% CI 3.601-49.415)
p-value: p=<0.001
BACKGROUND: Nonvalvular atrial fibrillation (NVAF) patients with low CHA2DS2-VASc scores still have a risk of atrial thrombus formation. This study aims to identify these patients' risk factors for intracardiac thrombus or sludge. METHODS: We conducted a retrospective study of 919 consecutive hospitalized NVAF or atrial flutter patients with a CHA2DS2-Vas score ≤ 1 (male) and ≤ 2 (female) who underwent transesophageal echocardiogram (TEE) before catheter ablation at Beijing An Zhen Hospital from November 2016 to December 2017. We collected the clinical and echocardiographic characteristics of the patients. RESULTS: Excluding seven patients with hypertrophic cardiomyopathy, 919 patients, including 17 identified left atrial appendage (LAA) thrombus/sludge and 902 without LAA thrombus/sludge, were included. Among 17 patients with LAA thrombus/sludge, 16 (94.1%) had non-paroxysmal AF. A subgroup analysis was conducted in 403 non-paroxysmal atrial fibrillation (AF) patients. 87.8% had spontaneous echo contrast (SEC), 59.3% had severe or more severe SEC, and 4.0% had thrombus/sludge. In the multivariable model, female (odds ratio OR 4.612, 95% CI 1.454-14.627, p = 0.009) and LA diameter ≥ 45 mm (OR 13.340, CI 3.601, 49.415, p< 0.001) remained significantly independently associated with LAA thrombus/sludge. CONCLUSION: Among patients with NVAF and CHA2DS2-VASc scores ≤ 1 (male) and ≤ 2 (female), those non-paroxysmal AF patients who were female and had an LA ≥ 45 mm still had a risk of LAA thrombus/sludge formation.
Cui et al. (Wed,) conducted a observational in Nonvalvular atrial fibrillation or atrial flutter with low CHA2DS2-VASc scores (n=919). Risk factors (female sex, LA diameter ≥ 45 mm) was evaluated on Left atrial appendage (LAA) thrombus/sludge (OR 13.340, 95% CI 3.601-49.415, p=<0.001). Among patients with nonvalvular atrial fibrillation and low CHA2DS2-VASc scores, female sex (OR 4.612) and left atrial diameter ≥45 mm (OR 13.340) were independently associated with LAA thrombus.