Add like
Add dislike
Add to saved papers

Atrial fibrillation type and renal dysfunction as important predictors of left atrial thrombus.

Heart 2019 September
OBJECTIVE: We aimed to identify predictors of left atrial appendage (LAA) thrombus in patients with atrial fibrillation (AF) and to enhance the prognostic value of the CHA2 DS2 -VASc score.

METHODS: Derivation cohort included 1033 consecutive AF patients referred for catheter ablation or direct current cardioversion, in whom transoesophageal echocardiography (TOE) was performed prior to the procedure. Logistic regression analysis was used to identify predictors of LAA thrombus on TOE. Receiver operating characteristic (ROC) curves were constructed to compare the newly developed score with the CHA2 DS2 and CHA2 DS2 -VASc scores in the derivation and the validation (n=320) cohort.

RESULTS: On TOE, LAA thrombus was present in 59 (5.7%) patients in the derivation cohort. Aside from variables encompassed by the CHA2 DS2 -VASc score, LAA thrombus predictors included AF type (persistent/'permanent' vs paroxysmal) and renal dysfunction. These predictors were incorporated into the CHA2 DS2 -VASc score. In ROC analysis, area under the curve (AUC) for the new score (CHA2 DS2 -VASc-RAF score) was significantly higher (0.81) than those for the CHA2 DS2 and CHA2 DS2 -VASc scores (0.71 and 0.70, respectively). In the validation cohort, the CHA2 DS2 -VASc-RAF score also performed significantly better (AUC of 0.88) than the CHA2 DS2 and CHA2 DS2 -VASc scores (AUC of 0.63 and 0.60, respectively).

CONCLUSION: In real-world AF patients with majority on oral anticoagulation, LAA thrombus was found in approximately 6%. Two variables not included in the CHA2 DS2 -VASc score (AF type and renal dysfunction) proved strong, independent predictors of LAA thrombus and might improve thromboembolic risk stratification.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app