Impact of Left Atrial or Left Atrial Appendage Thrombus on Stroke Outcome: A Matched Control Analysis

JoonNyung Heo; Hyungwoo Lee; Il Hyung Lee; Hyo Suk Nam; Young Dae Kim

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자료유형: 학술저널

저자정보: JoonNyung Heo (Department of Neurology Yonsei University College of Medicine Seoul Korea) Hyungwoo Lee (Department of Neurology Yonsei University College of Medicine Seoul Korea) Il Hyung Lee (Department of Neurology Yonsei University College of Medicine Seoul Korea) Hyo Suk Nam (Department of Neurology Yonsei University College of Medicine Seoul Korea) Young Dae Kim (Department of Neurology Yonsei University College of Medicine Seoul Korea)

저널정보: 대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중영문학회지 제25권 제1호

발행연도: 2023.1

수록면: 111 - 118 (8page)

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Background and Purpose Left atrial or left atrial appendage (LA/LAA) thrombi are frequently observed during cardioembolic evaluation in patients with ischemic stroke. This study aimed to investigate stroke outcomes in patients with LA/LAA thrombus. Methods This retrospective study included patients admitted to a single tertiary center in Korea between January 2012 and December 2020. Patients with nonvalvular atrial fibrillation who underwent transesophageal echocardiography or multi-detector coronary computed tomography were included in the study. Poor outcome was defined as modified Rankin Scale score >3 at 90 days. The inverse probability of treatment weighting analysis was performed. Results Of the 631 patients included in this study, 68 (10.7%) had LA/LAA thrombi. Patients were likely to have a poor outcome when an LA/LAA thrombus was detected (42.6% vs. 17.4%, P<0.001). Inverse probability of treatment weighting analysis yielded a higher probability of poor outcomes in patients with LA/LAA thrombus than in those without LA/LAA thrombus (P<0.001). Patients with LA/LAA thrombus were more likely to have relevant arterial occlusion on angiography (36.3% vs. 22.4%, P=0.047) and a longer hospital stay (8 vs. 7 days, P<0.001) than those without LA/LAA thrombus. However, there was no difference in early neurological deterioration during hospitalization or major adverse cardiovascular events within 3 months between the two groups. Conclusions Patients with ischemic stroke who had an LA/LAA thrombus were at risk of a worse functional outcome after 3 months, which was associated with relevant arterial occlusion and prolonged hospital stay.

#Atrial fibrillation #Ischemic stroke #Heart atria #Atrial appendage #Thrombosis #Prognosis

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