Biomarkers for Predicting Left Atrial or Left Atrial Appendage Thrombus in Anticoagulated Patients with Nonvalvular Atrial Fibrillation
Purpose. Although atrial fibrillation (AF) is often associated with thromboembolic complications, there is no definite biomarker for detecting the presence of thrombi in the left atrial (LA) or left atrial appendage (LAA) in patients with nonvalvular atrial fibrillation (NVAF). Methods. NVAF patient...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/1683142 |
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| author | Xue Zhou Zuolan Wang Shuang Dou Kangyin Chen Enzhao Liu Tong Liu Guangping Li Jingjin Che |
| author_facet | Xue Zhou Zuolan Wang Shuang Dou Kangyin Chen Enzhao Liu Tong Liu Guangping Li Jingjin Che |
| author_sort | Xue Zhou |
| collection | DOAJ |
| description | Purpose. Although atrial fibrillation (AF) is often associated with thromboembolic complications, there is no definite biomarker for detecting the presence of thrombi in the left atrial (LA) or left atrial appendage (LAA) in patients with nonvalvular atrial fibrillation (NVAF). Methods. NVAF patients who underwent transesophageal echocardiography (TEE) to evaluate LA/LAA thrombus and spontaneous echo contrast (SEC) before AF ablation were included. Multivariate logistic regression and receiver operating characteristic curve (ROC) analyses were performed to explore the independent risk factors of LA/LAA thrombus and indicate the best cutoff point. Results. Of the 260 consecutive subjects (mean age: 63.67 ± 9.39 years; 42% women), 45 (17.3%) patients were with LA/LAA thrombus, 131 (50.4%) were with SEC, and 84 (32.3%) were with neither thrombus nor SEC. The results of multivariate logistic regression analysis showed that N-terminal pro-B-type natriuretic peptide (NT-proBNP) (OR, 2.179; 95% CI: 1.191–3.987; p=0.012) and red cell distribution width (RDW) (OR, 2.398; 95% CI: 1.075–5.349; p=0.033) were independently correlated with the presence of LA/LAA thrombus but not D-dimer (OR, 0.999; 95% CI: 0.998–1.000; p=0.210). When all patients were divided into four groups based on the combination between RDW (cutoff value: 12.95%) and NT-proBNP levels (cutoff value: 368.9 ng/L), the rate of LA/LAA thrombus was the highest in the high RDW and NT-proBNP group. Conclusion. In anticoagulation patients with NVAF, elevated NT-proBNP and RDW are related to LA/LAA thrombus. Therefore, these might be considered as useful prognostic markers in the management and treatment of NVAF patients. |
| format | Article |
| id | doaj-art-2809a96ea80f495aaefeb9d4ffcb60e8 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-2809a96ea80f495aaefeb9d4ffcb60e82025-02-03T06:43:44ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/16831421683142Biomarkers for Predicting Left Atrial or Left Atrial Appendage Thrombus in Anticoagulated Patients with Nonvalvular Atrial FibrillationXue Zhou0Zuolan Wang1Shuang Dou2Kangyin Chen3Enzhao Liu4Tong Liu5Guangping Li6Jingjin Che7Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaChaoyang Central Hospital, Chaoyang, Liaoning 122000, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaPurpose. Although atrial fibrillation (AF) is often associated with thromboembolic complications, there is no definite biomarker for detecting the presence of thrombi in the left atrial (LA) or left atrial appendage (LAA) in patients with nonvalvular atrial fibrillation (NVAF). Methods. NVAF patients who underwent transesophageal echocardiography (TEE) to evaluate LA/LAA thrombus and spontaneous echo contrast (SEC) before AF ablation were included. Multivariate logistic regression and receiver operating characteristic curve (ROC) analyses were performed to explore the independent risk factors of LA/LAA thrombus and indicate the best cutoff point. Results. Of the 260 consecutive subjects (mean age: 63.67 ± 9.39 years; 42% women), 45 (17.3%) patients were with LA/LAA thrombus, 131 (50.4%) were with SEC, and 84 (32.3%) were with neither thrombus nor SEC. The results of multivariate logistic regression analysis showed that N-terminal pro-B-type natriuretic peptide (NT-proBNP) (OR, 2.179; 95% CI: 1.191–3.987; p=0.012) and red cell distribution width (RDW) (OR, 2.398; 95% CI: 1.075–5.349; p=0.033) were independently correlated with the presence of LA/LAA thrombus but not D-dimer (OR, 0.999; 95% CI: 0.998–1.000; p=0.210). When all patients were divided into four groups based on the combination between RDW (cutoff value: 12.95%) and NT-proBNP levels (cutoff value: 368.9 ng/L), the rate of LA/LAA thrombus was the highest in the high RDW and NT-proBNP group. Conclusion. In anticoagulation patients with NVAF, elevated NT-proBNP and RDW are related to LA/LAA thrombus. Therefore, these might be considered as useful prognostic markers in the management and treatment of NVAF patients.http://dx.doi.org/10.1155/2020/1683142 |
| spellingShingle | Xue Zhou Zuolan Wang Shuang Dou Kangyin Chen Enzhao Liu Tong Liu Guangping Li Jingjin Che Biomarkers for Predicting Left Atrial or Left Atrial Appendage Thrombus in Anticoagulated Patients with Nonvalvular Atrial Fibrillation Cardiology Research and Practice |
| title | Biomarkers for Predicting Left Atrial or Left Atrial Appendage Thrombus in Anticoagulated Patients with Nonvalvular Atrial Fibrillation |
| title_full | Biomarkers for Predicting Left Atrial or Left Atrial Appendage Thrombus in Anticoagulated Patients with Nonvalvular Atrial Fibrillation |
| title_fullStr | Biomarkers for Predicting Left Atrial or Left Atrial Appendage Thrombus in Anticoagulated Patients with Nonvalvular Atrial Fibrillation |
| title_full_unstemmed | Biomarkers for Predicting Left Atrial or Left Atrial Appendage Thrombus in Anticoagulated Patients with Nonvalvular Atrial Fibrillation |
| title_short | Biomarkers for Predicting Left Atrial or Left Atrial Appendage Thrombus in Anticoagulated Patients with Nonvalvular Atrial Fibrillation |
| title_sort | biomarkers for predicting left atrial or left atrial appendage thrombus in anticoagulated patients with nonvalvular atrial fibrillation |
| url | http://dx.doi.org/10.1155/2020/1683142 |
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