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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.


ABSTRACT:

Background

Our 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).

Methods

We conducted a subanalysis of a multicenter, prospective, observational study [the LATTEE registry]. Consecutive AF/AFl patients referred for cardioversion or ablation were enrolled.

Results

Of 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.

Conclusions

Our 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.

SUBMITTER: Uzieblo-Zyczkowska B 

PROVIDER: S-EPMC9611536 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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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.

Uziȩbło-Życzkowska Beata B   Kapłon-Cieślicka Agnieszka A   Gawałko Monika M   Budnik Monika M   Starzyk Katarzyna K   Wożakowska-Kapłon Beata B   Daniłowicz-Szymanowicz Ludmiła L   Kaufmann Damian D   Wójcik Maciej M   Błaszczyk Robert R   Hiczkiewicz Jarosław J   Łojewska Katarzyna K   Mizia-Stec Katarzyna K   Wybraniec Maciej M   Kosmalska Katarzyna K   Fijałkowski Marcin M   Szymańska Anna A   Gos Aleksandra A   Haberka Maciej M   Kucio Michał M   Michalski Błazej B   Kupczyńska Karolina K   Tomaszuk-Kazberuk Anna A   Wilk-Śledziewska Katarzyna K   Wachnicka-Truty Renata R   Koziński Marek M   Burchardt Paweł P   Krzesiński Paweł P  

Frontiers in cardiovascular medicine 20221012


<h4>Background</h4>Our 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).<h4>Methods</h4>We conducted a subanalysis of a multicenter, prospective, observational study [the LATTEE registry]. Consecutive AF/AFl patients referred for cardioversion or ablation were enrolled.<h4>Results</h4>Of the 3,109 patients included in the study, 1,276 were under age 65 (41%). Compared to n  ...[more]

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