In:
Archives of Medical Science, Termedia Sp. z.o.o.
Abstract:
We aimed to compare the prevalence of left atrial appendage
(LAA) thrombus and its predictors between old and young patients with atrial fibrillation (AF). Material and methods The study included 1970 patients aged ≥ 65 (n =
822 [41.7%] ) and 〈 65 (n = 1148 [58.3%]) referred for AF cardioversion or ablation preceded by transoesophageal echocardiography (TEE). Results Oral anticoagulation (OAC) was prescribed in 799 (97.2%) patients
aged ≥ 65 years and in 1054 (91.8%) of those aged 〈 65 years (p 〈 0.001).
In patients treated with OAC, those aged ≥ 65 years less often received vitamin K antagonist (VKA) (267 [33.4%] vs. 416 [39.5%] ) and more often
non-VKA-OAC (NOAC) (532 [66.6%] vs. 638 [60.5%], p = 0.008, p = 0.008) compared to patients 〈 65 years. On TEE, LAA thrombus was more often
observed in patients aged ≥ 65 years than those aged 〈 65 years (63 [7.7%]
vs. 46 [4.0%] , p 〈 0.001), with an absolute but not statistically significant
difference between patients aged 65–74 and ≥ 75 years (47 [7.3%] vs. 16
[8.8%] , p = 0.528). In patients aged ≥ 65 years, there was no difference in
the prevalence of LAA thrombus between patients treated with VKA and NOAC, in contrast to patients aged 〈 65 years, in whom such a difference
was observed (27 [6.5%] vs. 16 [2.5%], p = 0.002). In multivariate logistic regression, predictors of LAA thrombus in both age groups were older age,
non-paroxysmal AF, and heart failure, whereas only in patients aged 〈 65
years – VKA use, and in those aged ≥ 65 years – lower glomerular filtration rate and platelet count. Conclusions Despite OAC use, older patients with AF remain at high risk of
LAA thrombus formation. Older age, non-paroxysmal AF, and heart failure are predictors of LAA thrombus, irrespective of age.
Type of Medium:
Online Resource
ISSN:
1734-1922
,
1896-9151
Language:
Unknown
Publisher:
Termedia Sp. z.o.o.
Publication Date:
2021
detail.hit.zdb_id:
2203781-0
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