TY - JOUR
T1 - 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
AU - Uzieblo-Zyczkowska, B.
AU - Kaplon-Cieslicka, A.
AU - Gawalko, M.
AU - Budnik, M.
AU - Starzyk, K.
AU - Wozakowska-Kaplon, B.
AU - Danilowicz-Szymanowicz, L.
AU - Kaufmann, D.
AU - Wojcik, M.
AU - Blaszczyk, R.
AU - Hiczkiewicz, J.
AU - Lojewska, K.
AU - Mizia-Stec, K.
AU - Wybraniec, M.
AU - Kosmalska, K.
AU - Fijalkowski, M.
AU - Szymanska, A.
AU - Gos, A.
AU - Haberka, M.
AU - Kucio, M.
AU - Michalski, B.
AU - Kupczynska, K.
AU - Tomaszuk-Kazberuk, A.
AU - Wilk-Sledziewska, K.
AU - Wachnicka-Truty, R.
AU - Kozinski, M.
AU - Burchardt, P.
AU - Krzesinski, P.
N1 - Funding Information:
The LATTEE Registry was initiated on the Scientific Platform of the ‘Club 30' of the Polish Cardiac Society. The authors thank also Elzbieta Wabich (Gdańsk), Jan Budzianowski (Zielona Góra), Konrad Pieszko (Zielona Góra), Sebastian Liedtke (Gdańsk), Marek Szołkiewicz (Gdańsk), Małgorzata Maciorowska and Agnieszka Jurek (Warsaw), for their assistance in data collection.
Publisher Copyright:
Copyright © 2022 Uziȩbło-Życzkowska, Kapłon-Cieślicka, Gawałko, Budnik, Starzyk, Wożakowska-Kapłon, Daniłowicz-Szymanowicz, Kaufmann, Wójcik, Błaszczyk, Hiczkiewicz, Łojewska, Mizia-Stec, Wybraniec, Kosmalska, Fijałkowski, Szymańska, Gos, Haberka, Kucio, Michalski, Kupczyńska, Tomaszuk-Kazberuk, Wilk-Śledziewska, Wachnicka-Truty, Koziński, Burchardt and Krzesiński.
PY - 2022/10/12
Y1 - 2022/10/12
N2 - 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 CHA(2)DS(2)-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.
AB - 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 CHA(2)DS(2)-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.
KW - atrial fibrillation
KW - thromboembolic risk factors
KW - young age group
KW - left atrial thrombus
KW - transesophageal echocardiography
KW - SMOKING
KW - STROKE
KW - THROMBOEMBOLISM
KW - METAANALYSIS
KW - PREVALENCE
KW - MORTALITY
KW - IMPACT
KW - SCORE
U2 - 10.3389/fcvm.2022.973043
DO - 10.3389/fcvm.2022.973043
M3 - Article
C2 - 36312270
SN - 2297-055X
VL - 9
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
M1 - 973043
ER -