P3384Left atrial appendage pseudo-thrombus as an independent risk factor for ischaemic stroke in patients with non-valvular atrial fibrillation

P3384Left atrial appendage pseudo-thrombus as an independent risk factor for ischaemic stroke in patients with non-valvular atrial fibrillation

Abstract Background Left atrial appendage (LAA) pseudo-thrombus is a well recognised phenomenon in patients with atrial fibrillation (AF) undergoing cardiovascular CT (CCT). The clinical significance of LAA pseudothrombus on CCT, in those with non-valvular AF (NVAF) is unknown. Objectives To determi...

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Veröffentlicht in:European heart journal 2019-10, Vol.40 (Supplement_1)
Hauptverfasser: Nicol, E, Semple, T, Baleswaran, S, Wong, T O M
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Semple, T
Baleswaran, S
Wong, T O M
description Abstract Background Left atrial appendage (LAA) pseudo-thrombus is a well recognised phenomenon in patients with atrial fibrillation (AF) undergoing cardiovascular CT (CCT). The clinical significance of LAA pseudothrombus on CCT, in those with non-valvular AF (NVAF) is unknown. Objectives To determine the association of LAA pseudo-thrombus in those with NVAF and ischaemic stroke. Methods 216 consecutive patients with NVAF, referred for CCT (with both standard and 60-second delayed acquisitions) were assessed for the LAA pseudo-thrombus, LA and LAA dimensions and morphology, cardiovascular risk factors, treatment, and ischaemic stroke risk Results Mean age (±SD) was 65.0±10.6 years (range 32–89) and 70.8% were male. LAA pseudo-thrombus was present in 59/216 (27%) patients. Ischaemic stroke is more frequent with increasing age (OR 1.10 (95% confidence intervals (CI) 1.06, 1.16), p
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The clinical significance of LAA pseudothrombus on CCT, in those with non-valvular AF (NVAF) is unknown. Objectives To determine the association of LAA pseudo-thrombus in those with NVAF and ischaemic stroke. Methods 216 consecutive patients with NVAF, referred for CCT (with both standard and 60-second delayed acquisitions) were assessed for the LAA pseudo-thrombus, LA and LAA dimensions and morphology, cardiovascular risk factors, treatment, and ischaemic stroke risk Results Mean age (±SD) was 65.0±10.6 years (range 32–89) and 70.8% were male. LAA pseudo-thrombus was present in 59/216 (27%) patients. Ischaemic stroke is more frequent with increasing age (OR 1.10 (95% confidence intervals (CI) 1.06, 1.16), p&lt;0.0001), vascular disease (3.21 (1.18, 8.75) p=0.023), pseudo-thrombus on CCT (4.18 (1.97, 8.88) p&lt;0.0001), cauliflour LAA morphology (4.93 (1.06, 22.09) p=0.042), and increased LAA ostial area: LAA tortuosity (4.64 (1.57, 13.71) p=0.006). Age (1.09 (1.03, 1.15) p&lt;0.0001), vascular disease (4.07 (1.19, 13.98) p=0.026), cauliflour LAA morphology (15.01 (2,93, 76.81) p=0.001) and pseudothrombus on CCT (3.62 (1.38, 9.50), p=0.009) were independently associated with ischaemic stroke. Pseudothrombus remained an independent risk factor even after CHA2DS2-VASc was included (3.21 (1.22, 8.41), p=0.018). Conclusion Pseudothrombus on CCT is a common finding in patients with NVAF and has a strong positive association with ischaemic stroke. Inclusion of pseudothrombus on CCT in risk assessment is additive to CHA2DS2-VASc in prediction of ischaemic stroke risk in patients with NVAF.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz745.0260</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids></links><search><creatorcontrib>Nicol, E</creatorcontrib><creatorcontrib>Semple, T</creatorcontrib><creatorcontrib>Baleswaran, S</creatorcontrib><creatorcontrib>Wong, T O M</creatorcontrib><title>P3384Left atrial appendage pseudo-thrombus as an independent risk factor for ischaemic stroke in patients with non-valvular atrial fibrillation</title><title>European heart journal</title><description>Abstract Background Left atrial appendage (LAA) pseudo-thrombus is a well recognised phenomenon in patients with atrial fibrillation (AF) undergoing cardiovascular CT (CCT). The clinical significance of LAA pseudothrombus on CCT, in those with non-valvular AF (NVAF) is unknown. Objectives To determine the association of LAA pseudo-thrombus in those with NVAF and ischaemic stroke. Methods 216 consecutive patients with NVAF, referred for CCT (with both standard and 60-second delayed acquisitions) were assessed for the LAA pseudo-thrombus, LA and LAA dimensions and morphology, cardiovascular risk factors, treatment, and ischaemic stroke risk Results Mean age (±SD) was 65.0±10.6 years (range 32–89) and 70.8% were male. LAA pseudo-thrombus was present in 59/216 (27%) patients. Ischaemic stroke is more frequent with increasing age (OR 1.10 (95% confidence intervals (CI) 1.06, 1.16), p&lt;0.0001), vascular disease (3.21 (1.18, 8.75) p=0.023), pseudo-thrombus on CCT (4.18 (1.97, 8.88) p&lt;0.0001), cauliflour LAA morphology (4.93 (1.06, 22.09) p=0.042), and increased LAA ostial area: LAA tortuosity (4.64 (1.57, 13.71) p=0.006). Age (1.09 (1.03, 1.15) p&lt;0.0001), vascular disease (4.07 (1.19, 13.98) p=0.026), cauliflour LAA morphology (15.01 (2,93, 76.81) p=0.001) and pseudothrombus on CCT (3.62 (1.38, 9.50), p=0.009) were independently associated with ischaemic stroke. Pseudothrombus remained an independent risk factor even after CHA2DS2-VASc was included (3.21 (1.22, 8.41), p=0.018). Conclusion Pseudothrombus on CCT is a common finding in patients with NVAF and has a strong positive association with ischaemic stroke. Inclusion of pseudothrombus on CCT in risk assessment is additive to CHA2DS2-VASc in prediction of ischaemic stroke risk in patients with NVAF.</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqNkE1OwzAQRi0EEqVwBCRfIGWc2E6yRBV_UiVYdMEuchybuE3tyHaK4BJcGVcF1kgzYy_eNyM9hK4JLAjUxY2afK-Ej5sb1X-WlC0g53CCZoTleVZzyk7RDEjNMs6r13N0EcIGACpO-Ax9vRRFRVdKRyyiN2LAYhyV7cSbwmNQU-ey2Hu3a6eARSqLje3UgVA2Ym_CFmsho_NYpzZB9kLtjMQherdVCcajiCaxAb-b2GPrbLYXw34ahP-9qE3rzTAkztlLdKbFENTVzztH6_u79fIxWz0_PC1vV5msSshaVtOSyYIyJtO3qruSFLwDSQnNW6UoiDSlrsuS5rLlRHSMAugWOAOuWTFH7LhWeheCV7oZvdkJ_9EQaA5Smz-pzVFqc5CacnDMuWn8Z-QbdKyClg</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Nicol, E</creator><creator>Semple, T</creator><creator>Baleswaran, S</creator><creator>Wong, T O M</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191001</creationdate><title>P3384Left atrial appendage pseudo-thrombus as an independent risk factor for ischaemic stroke in patients with non-valvular atrial fibrillation</title><author>Nicol, E ; Semple, T ; Baleswaran, S ; Wong, T O M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c870-b59475c3455c59489d7136d0c4142bee40abeecf97742cb61ad5400fb06506f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nicol, E</creatorcontrib><creatorcontrib>Semple, T</creatorcontrib><creatorcontrib>Baleswaran, S</creatorcontrib><creatorcontrib>Wong, T O M</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nicol, E</au><au>Semple, T</au><au>Baleswaran, S</au><au>Wong, T O M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P3384Left atrial appendage pseudo-thrombus as an independent risk factor for ischaemic stroke in patients with non-valvular atrial fibrillation</atitle><jtitle>European heart journal</jtitle><date>2019-10-01</date><risdate>2019</risdate><volume>40</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract Background Left atrial appendage (LAA) pseudo-thrombus is a well recognised phenomenon in patients with atrial fibrillation (AF) undergoing cardiovascular CT (CCT). The clinical significance of LAA pseudothrombus on CCT, in those with non-valvular AF (NVAF) is unknown. Objectives To determine the association of LAA pseudo-thrombus in those with NVAF and ischaemic stroke. Methods 216 consecutive patients with NVAF, referred for CCT (with both standard and 60-second delayed acquisitions) were assessed for the LAA pseudo-thrombus, LA and LAA dimensions and morphology, cardiovascular risk factors, treatment, and ischaemic stroke risk Results Mean age (±SD) was 65.0±10.6 years (range 32–89) and 70.8% were male. LAA pseudo-thrombus was present in 59/216 (27%) patients. Ischaemic stroke is more frequent with increasing age (OR 1.10 (95% confidence intervals (CI) 1.06, 1.16), p&lt;0.0001), vascular disease (3.21 (1.18, 8.75) p=0.023), pseudo-thrombus on CCT (4.18 (1.97, 8.88) p&lt;0.0001), cauliflour LAA morphology (4.93 (1.06, 22.09) p=0.042), and increased LAA ostial area: LAA tortuosity (4.64 (1.57, 13.71) p=0.006). Age (1.09 (1.03, 1.15) p&lt;0.0001), vascular disease (4.07 (1.19, 13.98) p=0.026), cauliflour LAA morphology (15.01 (2,93, 76.81) p=0.001) and pseudothrombus on CCT (3.62 (1.38, 9.50), p=0.009) were independently associated with ischaemic stroke. Pseudothrombus remained an independent risk factor even after CHA2DS2-VASc was included (3.21 (1.22, 8.41), p=0.018). Conclusion Pseudothrombus on CCT is a common finding in patients with NVAF and has a strong positive association with ischaemic stroke. Inclusion of pseudothrombus on CCT in risk assessment is additive to CHA2DS2-VASc in prediction of ischaemic stroke risk in patients with NVAF.</abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz745.0260</doi></addata></record>
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title P3384Left atrial appendage pseudo-thrombus as an independent risk factor for ischaemic stroke in patients with non-valvular atrial fibrillation
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