Association Of Adipocytokines Serum Levels With Left Atrial Thrombus Formation In Atrial Fibrillation Patients On Oral Anticoagulation (Alert) – A Cross-Sectional Study

2020 ◽  
Author(s):  
Hermann Blessberger ◽  
Patrick Mueller ◽  
Hisaki Makimoto ◽  
Friederike Hauffe ◽  
Anita Meissner ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Oral Anticoagulation ◽  
Left Atrial ◽  
Thrombus Formation ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Cross Sectional

scholarly journals Diagnostic accuracy of D-dimer to detect left atrial thrombus in patients with atrial fibrillation: a systematic review and meta-analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Diaz-Arocutipa ◽  
A.C Gonzales-Luna ◽  
A Branez-Condorena ◽  
A.V Hernandez
Keyword(s):  
Atrial Fibrillation ◽  
Diagnostic Accuracy ◽  
Left Atrial ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Left Atrial Thrombus ◽  
Summary Receiver Operating Characteristic ◽  
Atrial Thrombus ◽  
Cross Sectional ◽  
D Dimer

Abstract Background There is limited evidence on the use of biomarkers to diagnose left atrial thrombus in atrial fibrillation. Purpose We evaluated the diagnostic accuracy of D-dimer to detect left atrial thrombus in patients with atrial fibrillation. Methods We searched four electronic databases from inception to December 16, 2020 for observational studies evaluating diagnostic accuracy of D-dimer. Reference standard was left atrial thrombus detected by transesophageal echocardiography. Study quality was assessed with the QUADAS-2 tool. We performed a bivariate random-effects meta-analysis to calculate the pooled sensitivity and specificity with their 95% confidence intervals (95% CI). In addition, a summary receiver operating characteristic curve and optimal cut-off were estimated. Results Eleven cross-sectional studies involving 4380 patients were included. The mean age ranged from 49.8 to 74.1 years and 70% of patients were men. Left atrial thrombus was present in 7% of cases. In seven studies, the pooled sensitivity of D-dimer at 500 ng/mL was 53% (95% CI, 26–79%) and the pooled specificity was 92% (95% CI, 80–97%). The pooled sensitivity of age-adjusted D-dimer was 35% (95% CI, 18–57%) and the pooled specificity was 100% (95% CI, 100–100%) in two studies. The optimal cut-off was 390 ng/mL in 10 studies with a pooled sensitivity of 68% (95% CI, 44–85%) and a pooled specificity of 73% (95% CI, 54–86%). The risk of bias was low or unclear for all domains. Concerns regarding applicability were generally low for almost all studies Conclusion Our meta-analysis suggests that D-dimer has the potential to be useful to the detection of left atrial thrombus in patients with atrial fibrillation. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Thrombus Formation in Left Atrium on Dabigatran Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-2 ◽  
Author(s):  
Priyank Shah ◽  
Priyam Mithawala ◽  
Donna Konlian ◽  
Aderemi Soyombo ◽  
Mahesh Bikkina
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Left Atrial ◽  
Thrombus Formation ◽  
Chronic Atrial Fibrillation ◽  
The United States ◽  
Thrombin Inhibitor ◽  
Left Atrial Thrombus ◽  
Nonvalvular Atrial Fibrillation ◽  
Atrial Thrombus

Dabigatran is a direct thrombin inhibitor, approved in the United States for stroke prevention in nonvalvular atrial fibrillation and prevention and treatment of thromboembolism. It has been also used in patients with documented left atrial thrombus, where treatment with dabigatran effectively led to thrombus resolution. We present a rare case of left atrial thrombus formation in a patient with chronic atrial fibrillation being treated with dabigatran 150 mg twice a day. The patient presented with multiple embolic strokes. There are only three such cases reported in the literature till date, all of whom had thrombus in the left atrium. The possible mechanisms of dabigatran failure include compensatory increase in upstream coagulation factors due to single level downstream blockade of thrombin, lack of inhibition of all available thrombin, and lack of monitoring measures that can be implemented in common clinical laboratories that lead to failure to assess adherence, which in turn can lead to dabigatran failure.

scholarly journals Left atrial thrombus formation within a few days of hospitalization in semi-acute ischemic heart disease despite no atrial fibrillation and mitral stenosis: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Keiko Okamura ◽  
Mitsuharu Kodaka ◽  
Junko Ichikawa ◽  
Kazuyoshi Ando ◽  
Makiko Komori
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Thrombus Formation ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Heparin Resistance

Abstract Background Currently, the occurrence of left atrial thrombus despite the provision of heparinization within a few days of hospitalization without atrial fibrillation (AF) and mitral stenosis (MS) is rarely reported. Case presentation A 71-year-old woman presented with chest discomfort and dyspnea. Examination revealed ST elevation with sinus rhythm, congestive heart failure, and moderate mitral regurgitation (MR) by transthoracic echocardiography (TTE). Diuretics, a coronary vasodilator, and unfractionated heparin (15,000 units/day) were administered. Four days after hospitalization, her C-reactive protein level had increased; therefore, TTE was repeated, revealing a thrombus in the left atrial appendage, which was probably affected by heparin resistance because of low antithrombin (49%). On day 5, the patient underwent emergency removal of the thrombus, mitral valve replacement, and coronary artery bypass. Conclusion Patients can exhibit low left ventricular contractility, even sinus rhythm without MS. Thus, TTE and subsequent coagulation tests including antithrombin must be performed to prevent thrombus.

scholarly journals Predictors of Left Atrial Thrombus and Short-Term Recurrence of Arrhythmia in Patients Undergoing Electrical Cardioversion for Atrial Fibrillation, a Single-Centre Experience

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Left Atrial ◽  
Thrombus Formation ◽  
Electrical Cardioversion ◽  
Left Atrial Thrombus ◽  
Atrial Volume ◽  
Short Term ◽  
Atrial Thrombus

Background: Systemic thromboembolism is a serious complication of electrical cardioversion. Even in the absence of such complications there exists a significant rate of arrhythmia recurrence post cardioversion. Aims: The aim of this study was to identify factors that may aid clinicians in identifying those patients at increased risk of atrial thrombus formation and short-term arrhythmia recurrence. Methods: One-hundred and twelve patients were retrospectively identified across a 2.5 year period as having undergone electrical cardioversion at the Gold Coast University Hospital for atrial fibrillation or atrial flutter. Demographic, clinical and echocardiogram data was analysed to identify potential predictors of thrombus, unsuccessful cardioversion and arrhythmia recurrence. Results: Cardioversion was successful in 87.6% of patients. Cardioversion was more successful initially in males (p<0.01) and those with reduced atrial volume (p<0.01) and higher left ventricular ejection fraction (p<0.01). Arrhythmia recurrence within 3 months occurred in 57.7% of patients. Recurrence was more likely in those with congestive heart failure (p<0.05) and a longer pre-cardioversion duration of arrhythmia (p<0.05). Spontaneous echo contrast was observed in 3 (2.6%) of patients, whilst left atrial thrombus was observed in 7 (6.2%) of patients. Potential predictors of thrombus were congestive heart failure (p<0.05) and increased left atrial volume (p<0.01). Conclusions: This retrospective study identified a number of factors that may useful in the clinical setting in predicting cardioversion success, both initially and short-term, in addition to predicting thrombus formation.

scholarly journals Atrial fibrillation with flutter episode in patient with mitral stenosis

2018 ◽  
Vol 41 (3) ◽  
pp. 134
Author(s):  
Deri Arara ◽  
Yerizal Karani
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Thrombus Formation ◽  
The Other ◽  
Left Atrial Thrombus ◽  
Atrial Thrombus ◽  
Common Etiology ◽  
Severe Degree ◽  
Rheumatic Heart

Mitral stenosis (MS) is a condition which happened because of congenital or acquired event. The most common etiology of MS in Indonesia is Rheumatic Heart Disease (RHD). Chronic inflammation on the mitral valve could lead to stenosis from mild to severe degree. Mitral stenosis could lead to many complications such as pulmonary hypertension and atrial fibrillation (AF). The prevalence of AF in patients with MS is related to the severity of valve obstruction and patient age. AF event in patient with MS could be happen because of Left Atrial (LA) dilatation of the patient. The mechanism that responsible for AF in patient with MS is a complex one. AF even with or without atrial flutter episode could lead a deterioration of patient hemodynamic. In the other way, the patient also predisposes to left atrial thrombus formation and systemic embolic events. Good awareness in diagnosis and management of atrial fibrillation in patient with MS are mandatory to reduce the morbidity and mortality.

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