scholarly journals Efficacy and safety of anticoagulant treatment for non-valvular atrial fibrillation in multimorbid patients

Kardiologiia ◽  
2020 ◽  
Vol 60 (2) ◽  
pp. 61-68
Author(s):  
N. V. Izmozherova ◽  
A. A. Popov ◽  
V. M. Bakhtin
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Oral Anticoagulants ◽  
Anticoagulant Treatment ◽  
Nonvalvular Atrial Fibrillation ◽  
Cross Sectional ◽  
Group 2 ◽  
High Level ◽  
Multimorbid Patients ◽  
Group 1

Objective. Assessment of the safety and efficacy of anticoagulant treatment in patients with nonvalvular atrial fibrillation (AF) in a multimorbidity setting.Materials and Methods. The cross-sectional study included 104 patients diagnosed with nonvalvular AF and followed in the medical facilities of Yekaterinburg. The subjects were interviewed, anthropometric measurements were made, and the risk of thromboembolic complications was evaluated using the CHA2DS2-VASc score. The Charlson multimorbidity index was calculated, and patients were divided into two groups: Group 1 with a low level of multimorbidity (not more than 5 points) and Group 2 with a high level of multimorbidity (6 points or more). The data are presented as a median and interquartile range (25%; 75%).Results.The study population included 40 males and 64 females. The median age was 71 (62.5; 80) years. The level of multimorbidity was estimated as 5 (3; 6) points. Group 1 included 64 patients, and Group 2 included 40 patients. Thirty-nine percent of the sample patients had a paroxysmal form of AF, 10% had a persistent form, and 51% had permanent AF. The group of patients with a high level of multimorbidity included more patients with permanent AF and fewer patients with paroxysmal AF as compared with a moderate level of multimorbidity (p<0.01). Anticoagulant treatment was indicated for 92 (88.5%) patients. It was administered to 70.7% of patients; 29.3% did not receive it. Among patients receiving anticoagulants, warfarin was administered to 18.5%, and new oral anticoagulants (NOACs) were administered to 81.5%. Complications were reported in 15.2% of anticoagulant treatment cases. Bleeding was reported in 21.7% of cases of warfarin administration and 12.5% of cases of NOAC treatment (p=0.32). The median number of risk factors for bleeding per patient was 5 (4; 5.5). The Charlson index and the total number of risk factors are significantly correlated (R=0.37, p<0.05).Conclusion. In real-world clinical practice in Ekaterinburg, Russia, 7 of 10 patients with AF for whom anticoagulant treatment was indicated actually received it; NOACs are prescribed four times more often than warfarin. With a higher level of multimorbidity, the risk of bleeding under the pressure of anticoagulant treatment increases; thus, NOACs should be preferred over warfarin for treatment of multimorbid patients.

scholarly journals PRescriptiOn PattERns of Oral Anticoagulants in Nonvalvular Atrial Fibrillation (PROPER study)

2015 ◽  
Vol 23 (4) ◽  
pp. 384-391 ◽  
Author(s):  
Ozcan Basaran ◽  
Nesrin Filiz Basaran ◽  
Edip Guvenc Cekic ◽  
Ibrahim Altun ◽  
Volkan Dogan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Real World ◽  
Therapy Group ◽  
Oral Anticoagulants ◽  
Inappropriate Drug ◽  
Nonvalvular Atrial Fibrillation ◽  
Prescription Patterns ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Introduction: Inappropriate use of oral anticoagulants (OACs) have not been well investigatedand, however, may be frequent in real-world practice in patients with nonvalvular atrial fibrillation (NVAF). This study was designed to evaluate the prescription patterns and appropriateness of OACs in patients with NVAF in real-world clinical settings. Methods: We performed a prospective, observational study (NCT02366338). A total of 148 patients with NVAF were screened for OAC prescription. Appropriateness of prescribing was evaluated using 9 criteria of the Medication Appropriateness Index (MAI): indication, choice, dosage, modalities and practicability of administration, drug–drug interactions, drug–disease interactions, duplication, and duration. For each criterion, the evaluator has to rate whether the medication is (A) appropriate, (B) inappropriate but with limited clinical importance, and (C) inappropriate. Results: Of 148 patients, 73 (50%) were on warfarin (group 1), 39 (26%) were on rivaroxaban (group 2), and 36 (24%) were on dabigatran therapy (group 3). The MAI showed that 83% of group 1, 28% of group 2, and 47% of group 3 patients had at least 1 inappropriate criterion. Moreover, according to the choice criterion, 37% of group 1, 8% of group 2 and 5% of group 3 were rated as inappropriate, and dosage was not appropriate in 77% of group 1, 23% of group 2, and 42% of group 3. Conclusion: Inappropriate drug use is frequent among patients with NVAF not only for warfarin but also for NOACs. Although there is an apparent improvement in thromboprophylaxis of NVAF, much more effort is needed for appropriate use of OACs.

Compliance to antithrombotic therapy in elderly and senile patients with atrial fibrillation.

2019 ◽  
Author(s):  
М.В. Хруслов ◽  
М.А. Карпенко ◽  
Т.В. Вавилова ◽  
И.В. Пономарева
Keyword(s):  
Atrial Fibrillation ◽  
Antithrombotic Therapy ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Laboratory Model ◽  
Nonvalvular Atrial Fibrillation ◽  
Effective Prevention ◽  
Group 2 ◽  
Group 1

Введение. Приверженность к приему антикоагулянтов является одним из ключевых компонентов эффективной профилактики тромбоэмболических осложнений. Цель исследования: оценка комплаентности пациентов пенсионного возраста, которым назначали прямые оральные антикоагулянты (ПОАК) по поводу неклапанной фибрилляции предсердий (ФП), и выяснение причин ее снижения. Материалы и методы. В ходе исследования осуществляли наблюдение за 244 пациентами с неклапанной ФП. В зависимости от вида принимаемых оральных антикоагулянтов все пациенты были разделены на 2 группы: 1я группа 124 человека, которые принимали ПОАК 2я группа 120 человек, которые принимали варфарин и наблюдались в системе централизованного мониторинга международного нормализованного отношения (МНО). Срок наблюдения составил 1 год. Результаты. Через 1 год от момента назначения препаратов назначения врача соблюдали только 22,6 пациентов 1й группы во 2й группе пациентов никто не прекратил прием варфарина, что указывало на более высокую приверженность к терапии. Заключение. Одним из способов повышения качества и безопасности антитромботической терапии у пациентов, принимающих антагонисты витамина К, является внедрение в клиническую практику системы централизованного мониторинга МНО, которая представляет собой новую клиниколабораторную Introduction. Adherence to anticoagulants is one of the key components of effective prevention of thromboembolic complications. Aim: to assess the compliance of patients of retirement age who were prescribed direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (AF), and to determine the reasons for its reduction. Materials and methods. We monitored 244 patients with nonvalvular AF that were divided into 2 groups: Group 1 124 patients who took DOACs Group 2 120 patients who took warfarin and were observed in the system of centralized monitoring of international normalized ratio (INR). The observation period was 1 year. Results. After 1 year from the moment of drugs prescribing only 22.6 of patients from Group 1 followed the prescription no one patient from Group 2 stopped taking warfarin that indicated a higher adherence to therapy. Conclusion. One of the ways to improve the quality and safety of antithrombotic therapy in patients taking vitamin K antagonists is to introduce into the clinical practice a system of centralized monitoring of INR that is a new clinical and laboratory model of remote interaction between patient and medical specialist.

Abstract 15073: Best Anticoagulation Strategy for Stroke Prophylaxis in Atrial Fibrillation Patients With Amyloidosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sanghamitra Mohanty ◽  
CHINTAN G TRIVEDI ◽  
Joseph Gallinghouse ◽  
Domenico G Della Rocca ◽  
Carola Gianni ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Oral Anticoagulants ◽  
Bleeding Complications ◽  
Considerable Proportion ◽  
Medical Procedure ◽  
Bleeding Events ◽  
Full Dose ◽  
Half Dose ◽  
Group 2 ◽  
Group 1

Background: A considerable proportion of elderly patients are known to have coexistent atrial fibrillation (AF) and amyloidosis. Both conditions increase stroke risk. Objective: We evaluated the best anticoagulation strategy in a series of AF patients with amyloidosis. Methods: Consecutive AF patients with coexistent amyloidosis undergoing catheter ablation at our center were included in the analysis. Based on the stroke-prophylaxis approach they were divided into 2 groups; group 1: left atrial appendage occlusion (LAAO) with Watchman and group 2: oral anticoagulation. Following LAAO, all patients remained on full dose non-vitamin K oral anticoagulants (NOAC) for 45 days. Transesophageal echocardiogram (TEE) was performed at 45 days to assess completeness of closure. If the occlusion was complete, patients were kept on aspirin, 81 mg/day for long-term. In case of leak or dense ‘smoke’ in the left atrium (LA) or enlarged LA, they were prescribed half-dose NOAC. NOACs included dabigatran, apixaban, endoxaban and rivaroxaban. Group 2 patients remained on full-dose NOAC during the whole study period (1 year). All patients were prospectively followed up for 1 year. Results: A total of 87 patients were included in the analysis; group 1: 56 and group 2: 31 . CHA 2 DS 2 -VASc score was comparable between the groups (gr. 1: 3.7±1.6 and gr. 2: 3.2±1.7, p=0.18). The most commonly used NOACs were apixaban (45, 51.7%) and rivaroxaban (34, 39%). After the 45-day TEE, 34 patients from group 1 remained on baby-aspirin and 22 on half-dose NOAC. Of the 22, 12 patients had leaks <5 mm, 6 had large LA (mean diameter 5.2±1.4 cm) and 4 patients had dense LA smoke. At 1-year follow-up, 3 stroke and 1 transient ischemic attack were reported in group 1 on baby-aspirin (4/34, 11.8%). No stroke or bleeding complications occurred in the 22 patients on half-dose NOAC. In group 2 patients on full-dose OAC, a total of 5 (5/31, 16.1%) bleeding events (1 subdural hematoma and 4 GI bleedings) were recorded. Additionally, a stroke was reported that happened during brief discontinuation of OAC for another medical procedure. Conclusion: In our series of patients with coexistent AF and amyloidosis, half-dose NOAC following LAA occlusion procedure was observed to be the safest stroke-prophylaxis strategy.

P4766Edoxaban Treatment in routiNe clinical prActice for patients with atrial fibrillation (AF) in Europe (ETNA-AF-Europe): 1-year follow-up according to body mass index

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Weiss ◽  
R De Caterina ◽  
P Kelly ◽  
P Monteiro ◽  
J C Deharo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Weight ◽  
Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Normal Weight ◽  
Routine Practice ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have substantially improved anticoagulation therapy for prevention of stroke and systemic embolism in patients with atrial fibrillation (AF), and available routine care data have so far broadly confirmed the safety of different NOACs in routine practice. However, such data for edoxaban are scarce, especially in extremely low and high body weight (BW). These extreme BWs may affect the bioavailability, distribution, and half-life of NOACs and, consequently, outcomes of treatment. Methods We analysed outcomes in normal-weight (BMI 18.5–25) vs overweight (BMI 25–30) and obese (BMI >30) patients enrolled into the ETNA-AF-Europe observational study (NCT02944019) collecting information on patients treated with edoxaban in 825 sites in 10 European countries. This snapshot analysis set includes data of 7,672 patients (56.3% of all enrolled patients) which have completed their 1-year follow-up visit (mean follow-up: 343.5 days). Results Median patient age was 74 years for all patients, 76 years for patients with a BMI 18.5–25 (group 1), 75 years for patients with BMI 25–30 (group 2), and 72 for patients with a BMI >30 (group 3). CrCl was 64 mL/min for patients with a BMI 18.5–25, 68 mL/min for patients with BMI 25–30, and 72 mL/min for patients with a BMI >30. The CHA2DS2-VASc (mean 3.1±1.38) and HAS-BLED (mean 2.5±1.10) score did not differ significantly between groups. As expected, diabetes and hypertension were significantly less prevalent in leaner patients and - accordingly - inversely correlated to age. There was no correlation between body weight and life-threatening bleeding (group 1: 0.28%; group 2: 0.40%; group 3: 0.14%). Also, stroke rates (group 1: 0.74%; group 2: 0.81%; group 3: 0.76%) did not differ between groups. Conclusion BMI, within the range here assessed, does not affect 1-year outcomes in European AF patients treated with edoxaban. Acknowledgement/Funding Daiichi Sankyo Europe GmbH, Munich, Germany

scholarly journals Influence of type and duration of training on the presence of an abnormal ECG in high-performance athletes

Heart Asia ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. e011120
Author(s):  
Geoffrey Verrall ◽  
Angus Hains ◽  
Bronte Ayres ◽  
Richard Hillock
Keyword(s):  
Oxygen Uptake ◽  
Maximal Oxygen Uptake ◽  
High Performance ◽  
Ecg Changes ◽  
Cross Sectional ◽  
Group 2 ◽  
European Society Of Cardiology ◽  
High Level ◽  
And Training ◽  
Group 1

ObjectiveTo undertake an ECG in high level athletes to determine the morphology of the ECG and to assess the influences on the ECG of the amount of time in a high-performance programme and the type of sport played.DesignCross-sectional cohort study.SettingHigh-performance sports programme.InterventionsCurrent symptoms (questionnaire) and length of time in a high-performance sports programme were recorded. Sports were classified as either high maximal oxygen uptake continuous, high maximal oxygen uptake repeated effort or static. An ECG was performed and classified by 2010 European Society of Cardiology guidelines into Groups 0 (normal), Group 1 (common and training-related ECG changes) and Group 2 (uncommon and training unrelated ECG changes).ResultsThe following were recorded: length of time in high performance sport programme (mean 2.3 years), type of sport (Continuous 103, Repeated effort 133, Static 37), ECG changes Group 0 (n=83, 31%), Group 1 (n=173, 63%) and Group 2 (n=17, 6.2%). Athletes with an increased length of time in a high performance programme demonstrated a higher likelihood of Group 2 ECG changes when compared with Groups 0 and 1 (p=0.05). The questionnaire did not help detect athletes with Group 2 ECG changes.ConclusionsThis study demonstrates that an increased length of time in a high performance programme was associated with an increased number of detectable Group 2 ECG changes. Overall, the further investigation rate was 6.2%.

Effect of Weekly Training Frequency With the Nordic Hamstring Exercise on Muscle-Strain Risk Factors in Football Players: A Randomized Trial

2020 ◽  
Vol 15 (7) ◽  
pp. 1026-1033
Author(s):  
Thales M. Medeiros ◽  
João B. Ribeiro-Alvares ◽  
Carolina G. Fritsch ◽  
Gabriel S. Oliveira ◽  
Lucas Severo-Silveira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Exercise Training ◽  
Randomized Trial ◽  
Peak Torque ◽  
Football Players ◽  
Muscle Strain ◽  
Exercise Training Program ◽  
Group 2 ◽  
High Level ◽  
Group 1

Purpose: To examine the differences between performing Nordic hamstring exercises once or twice a week on hamstring eccentric strength and other muscle-strain risk factors in high-level football players. Methods: In this randomized trial, 32 football players (18–23 y old) completed an 8-week Nordic hamstring exercise training program in 1 of 2 experimental groups: group 1 (once a week; n = 15) and group 2 (twice a week; n = 17). Knee-flexor/extensor peak torques and biceps femoris long-head muscle architecture were assessed through isokinetic dynamometry and ultrasonography, respectively, before and after the training programs. Analysis of covariance, effect sizes (ESs), and t tests for percentage change were used to assess the effect of the 2 interventions on the outcome measures. Results: Group 2 demonstrated higher hamstring concentric peak torque than group 1 posttraining (155–164 vs 149–158 N·m; P = .043; ES = 0.27), although there was also a statistical trend for higher hamstring eccentric peak torque (212–234 vs 198–221 N·m; P = .098; ES = 0.37), hamstring-to-quadriceps conventional ratio (0.56–0.59 vs 0.54–0.57; P = .089; ES = 0.31), and hamstring-to-quadriceps functional ratio (0.76–0.84 vs 0.71–0.79; P = .076; ES = 0.50). No between-groups differences were found for muscle thickness (P = .864; ES = 0.12), pennation angle (P = .289; ES = 0.18), fascicle length (P = .406; ES = 0.03), and quadriceps concentric peak torque (P = .340; ES = 0.02). Conclusion: Only the Nordic hamstring exercise training program performed twice a week strengthened the hamstrings of high-level football players, while similar changes in muscle architecture occurred with both once- and twice-weekly sessions.

scholarly journals Demographic, clinical, and functional determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jose María Mostaza ◽  
Carmen Suarez ◽  
Jose María Cepeda ◽  
Luis Manzano ◽  
Demetrio Sánchez ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Atrial Fibrillation ◽  
Oral Anticoagulation ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Female Gender ◽  
Antithrombotic Treatment ◽  
Nonvalvular Atrial Fibrillation ◽  
Cross Sectional

Abstract Background This study assessed the sociodemographic, functional, and clinical determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation (NVAF) attended in the internal medicine setting. Methods A multicenter, cross-sectional study was conducted in NVAF patients who attended internal medicine departments for either a routine visit (outpatients) or hospitalization (inpatients). Results A total of 961 patients were evaluated. Their antithrombotic management included: no treatment (4.7%), vitamin K antagonists (VKAs) (59.6%), direct oral anticoagulants (DOACs) (21.6%), antiplatelets (6.6%), and antiplatelets plus anticoagulants (7.5%). Permanent NVAF and congestive heart failure were associated with preferential use of oral anticoagulation over antiplatelets, while intermediate-to high-mortality risk according to the PROFUND index was associated with a higher likelihood of using antiplatelet therapy instead of oral anticoagulation. Longer disease duration and institutionalization were identified as determinants of VKA use over DOACs. Female gender, higher education, and having suffered a stroke determined a preferential use of DOACs. Conclusions This real-world study showed that most elderly NVAF patients received oral anticoagulation, mainly VKAs, while DOACs remained underused. Antiplatelets were still offered to a proportion of patients. Longer duration of NVAF and institutionalization were identified as determinants of VKA use over DOACs. A poor prognosis according to the PROFUND index was identified as a factor preventing the use of oral anticoagulation.

scholarly journals Impacts of hemoglobin levels and platelet counts on clinical outcomes in patients with atrial fibrillation: oral anticoagulant use for patients with anemia and/or thrombocytopenia

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T Chao ◽  
Y.H Chan ◽  
G.Y.H Lip ◽  
S.A Chen
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Outcomes ◽  
Major Bleeding ◽  
Oral Anticoagulant ◽  
Oral Anticoagulants ◽  
High Risk Population ◽  
Group 3 ◽  
Composite Risk ◽  
Group 2 ◽  
Group 1

Abstract Background Hemoglobin (Hgb) levels and platelet (PLT) counts have beeen associated with adverse clinical outcomes in some patients with cardiovascular conditions. We aimed to assess the risks of clinical events among patients with atrial fibrillation (AF) in relation to Hgb levels and PLT counts. Second, we investigated clinical outcomes on warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) compared to no oral anticoagulant use (non-OAC), in different Hgb and PLT strata. Methods We used medical data from a multi-center healthcare system in Taiwan which included 37,074 AF patients. Patients were categorized into 3 groups based on their Hgb levels and PLT counts: Group 1 (Hgb&gt;10g/dL and PLT&gt;100K/uL; n=29,147), Group 2 (Hgb&lt;10g/dL or PLT&lt;100K/uL; n=7,078) and Group 3 (Hgb&lt;10g/dL and PLT&lt;100K/uL; n=849). Patients in each category were further stratified as 3 groups according to their stroke prevention strategies; that is, non-OAC, warfarin or NOACs. Results A higher Hgb level and/or PLT count was associated with a higher risk of ischemic stroke/systemic embolism (IS/SE), but lower risks of intracranial hemorrhage (ICH) and major bleeding. The composite risks of IS/SE, ICH and major bleeding were higher in Group 3 or Group 2, compared to Group 1 (6.75%/yr versus 6.41%/yr versus 4.13%/yr). Compared to non-OACs, the use of warfarin was not associated with a lower composite risk of IS/SE, ICH and major bleeding in the 3 groups. NOACs were associated with a lower composite risk in Group 1 (aHR 0.68, 95% CI 0.60–0.76) and Group 2 (aHR 0.73, 95% CI 0.53–0.99), but was non-significant in Group 3 (aHR 0.73, 95% CI 0.17–3.07) (Figure). The net clinical benefits were consistently positive in different weight models, in favor of NOAC use, in Group 2 and its subgroups with either anemia or thrombocytopenia. Conclusions AF patients with anemia and/or thrombocytopenia were a high-risk population. Compared to no OAC use, NOACs were associated with significantly better clinical outcomes for patients with advanced anemia (Hgb&lt;10g/dL) or thrombocytopenia (PLT&lt;100K/uL), but not for those with both conditions. Harms or benefits of NOACs should be carefully evaluated and balanced in this population. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals High level of growth differentiation factor 15 and lower left ventricular ejection fraction as predictors of left atrial thrombosis in patients with nonvalvular atrial fibrillation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A.V Belokurova ◽  
T.P Gizatulina ◽  
N.Y.U Khorkova ◽  
L.U Martyanova ◽  
T.I Petelina ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Roc Analysis ◽  
Left Ventricular ◽  
Growth Differentiation Factor 15 ◽  
Differentiation Factor ◽  
Group 2 ◽  
High Level ◽  
Group 1

Abstract Background The presence of left atrial/left atrial appendage (LA/LAA) thrombus is used as a surrogate marker of potential stroke in patients (pts) with atrial fibrillation (AF). Purpose To assess the role of growth differentiation factor 15 (GDF-15) level, clinical and echocardiographic (EchoCG) data as predictors of LA/LAA thrombus in pts with nonvalvular AF. Methods Out of 158 pts with nonvalvular AF admitted to Cardiology Center for radiofrequency ablation or elective cardioversion in 2019–2020 2 groups were formed according to transesophageal EchoCG results: group 1 included pts without LA/LAA thrombus (n=102, mean age 59.5±6.0 years) and group 2 (n=42, mean age 60.9±8.8 years) – pts with LA/LAA thrombus. Arterial hypertension was found in 93 pts of group 1 (91%) and in 40 pts of group 2 (95%, p=0.42), coronary artery disease - in 53 pts (52%) and 29 pts (69%), respectively (p=0.06). Both groups did not differ in frequency and spectrum of oral anticoagulants administration. General clinical assessment, EchoCG, and laboratory tests were performed, including GDF-15 (pg/ml) levels using Human GDF-15/MIC-1 ELISA kit and NT-proBNP (pg/ml) in blood. Results Pts with LA/LAA thrombus more often had persistent AF, while paroxysmal AF was more common in pts without thrombus. There was a tendency to more significant congestive heart failure in group 2. Mean CHA2DS2-VASc score was higher in pts with LA/LAA thrombus, also there was a tendency to a larger proportion of pts with scores ≥3. According to EchoCG data, sizes and volumes of both atria, right ventricle, end-systolic volume, left ventricular (LV) size, pulmonary artery systolic pressure and LV mass index were higher in group 2; LV ejection fraction (LVEF) was normal in both groups, but it was significantly lower in pts with LA/LAA thrombus: 59.1±5.1 and 64.0±7.3, respectively (p&lt;0.001). GDF-15 and NT-proBNP levels were significantly higher in group 2 compared to group 1: p=0.00025 and p=0.ehab724.048801 respectively. According to ROC analysis cut-off were set at level &gt;935.0 pg/ml for GDF-15 (AUC=0.705, 95% CI 0.609–0.800, p&lt;0.001) and &gt;143 pg/ml for NT-proBNP (AUC=0.759, 95% CI 0.670–0.849, p&lt;0.001). Multivariate logistic regression revealed the following variables as independent predictors of LAAT: GDF-15 &gt;935.0 pg/ml (OR=4.132, 95% CI 1.305–13.084) and LVEF (OR=0.859, 95% CI 0.776–0.951). According to ROC analysis, the model had a good quality: AUC=0.776 (p&lt;0.001), sensitivity was 78.3%., specificity - 78.3%. Conclusion High level of GDF-15 (&gt;935.0 pg/ml) along with lower LVEF are independent predictors of LA/LAA thrombus in pts with nonvalvular AF. FUNDunding Acknowledgement Type of funding sources: None.

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