Arrhythmias & electrophysiology
Predictors of left atrial thrombi for subsequent thromboembolisms: Risk factors derived from echocardiography
Authors' conclusion
In patients with LATs, large thrombus size, reduced left ventricular ejection fraction, and thrombus mobility were associated with subsequent thromboembolism. UST was associated with fewer adverse clinical outcomes in patients with ≥2 risk factors.
Study context
- Population
- Patients with left atrial thrombi (LATs) who underwent morphological assessment of LAT using echocardiographypatients from 15 centers
- Participants
- 206 patients
- Exposure
- Associations between clinical and echocardiographic variables and the occurrence of symptomatic thromboembolism
- High-risk groupn = 52 [25.2%]
- Low-risk groupn = 154 [74.8%]
- Outcome
- thromboembolism
- Follow-up
- During after echocardiographic diagnosis (651 days; interquartile range 174-1316 days)
Methodological detailsconsecutively enrolled
- Consecutively enrolled
Main finding
As reported in the abstract
Patients who developed thromboembolism
19 patients
9.2%
Observational data: associations, not effects.
Further findings
Independent predictors of thromboembolism (Cox regression analysis)
| HR (95% CI) | P value | ||
|---|---|---|---|
| LAT maximum length > 20 mm | 2.63 (1.03–6.68) | P = 0.043 | |
| Reduced left ventricular ejection fraction (≤40%) | 2.95 (1.14–7.63) | P = 0.026 | |
| Thrombus mobility | 3.40 (1.27–9.11) | P = 0.015 | |
| 0.10.31310Hazard ratio (log scale) |
Incidence of thromboembolism
Urgent surgical thrombectomy (UST)
- Incidence of thromboembolism: P<.001
- Urgent surgical thrombectomy (UST): P=.025
Adverse outcomes (all-cause mortality, heart failure hospitalizations, major bleeding, and thromboembolisms) with vs without UST, in high-risk patients · 90 days
- UST vs no UST, adverse outcome rate
- 0% vs 35.6%
- Log-rank, P=.048
Original publication
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