학술논문
Risk factors for left atrial thrombus in younger patients (aged < 65 years) with atrial fibrillation or atrial flutter: Data from the multicenter left atrial thrombus on transesophageal echocardiography (LATTEE) registry
Document Type
article
Author
Beata Uziȩbło-Życzkowska; Agnieszka Kapłon-Cieślicka; Monika Gawałko; Monika Budnik; Katarzyna Starzyk; Beata Wożakowska-Kapłon; Ludmiła Daniłowicz-Szymanowicz; Damian Kaufmann; Maciej Wójcik; Robert Błaszczyk; Jarosław Hiczkiewicz; Katarzyna Łojewska; Katarzyna Mizia-Stec; Maciej Wybraniec; Katarzyna Kosmalska; Marcin Fijałkowski; Anna Szymańska; Aleksandra Gos; Maciej Haberka; Michał Kucio; Błazej Michalski; Karolina Kupczyńska; Anna Tomaszuk-Kazberuk; Katarzyna Wilk-Śledziewska; Renata Wachnicka-Truty; Marek Koziński; Paweł Burchardt; Paweł Krzesiński
Source
Frontiers in Cardiovascular Medicine, Vol 9 (2022)
Subject
Language
English
ISSN
2297-055X
Abstract
BackgroundOur aim was to assess the characteristics and to identify predictors of left atrial thrombus (LAT) in patients under age 65 with atrial fibrillation (AF) or atrial flutter (AFl).MethodsWe conducted a subanalysis of a multicenter, prospective, observational study [the LATTEE registry]. Consecutive AF/AFl patients referred for cardioversion or ablation were enrolled.ResultsOf the 3,109 patients included in the study, 1,276 were under age 65 (41%). Compared to non-LAT patients, those with LAT (n = 76) had higher CHA2DS2-VASc score (p < 0.001), more frequently had non-paroxysmal AF/AFl (p < 0.001), heart failure (p < 0.001), history of diabetes mellitus (p = 0.001), transient ischemic attack (p = 0.04), coronary artery disease (p = 0.02), and chronic kidney disease (p < 0.001). The LAT patients were also more often smokers (p = 0.004) and were more frequently treated with vitamin K antagonists (VKAs) (p < 0.001). Transthoracic echocardiography revealed a higher left atrial area (p < 0.001), lower left ventricular ejection fraction (LVEF) (p < 0.001), and lower value of LA appendage emptying volume in LAT than in non-LAT patients (p < 0.001). LVEF (OR 2.95; 95% CI: 1.32–6.59, p = 0.008), non-paroxysmal AF/AFl (OR 7.1; 95% CI: 2.05–24.63, p = 0.002) and treatment with VKAs (OR 4.92; 95% CI: 2.48–9.75, p < 0.001) were identified as independent predictors of LAT in younger patients.ConclusionsOur study, which focused on younger patients with AF/AFl, indicated substantial clinical and echocardiographic differences between participants with and without LAT. In the AF/AFl patients younger than age 65, the independent predictors of LAT included non-paroxysmal AF/AFl, lower LVEF, and treatment with VKAs.