Affiliation:
1. 1 Department of Cardiovascular Medicine, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang, People's Republic of China
2. 2 Department of Facial Features, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang, People's Republic of China
Abstract
Background
Patients with atrial fibrillation are at risk for ischemic stroke, even with low CHA2DS2-VASc scores. The left atrial appendage is a known site of thrombus formation in individuals with atrial fibrillation.
Methods
We conducted a prospective study, enrolling patients with nonvalvular atrial fibrillation and CHA2DS2-VASc scores of 0 or 1. Patients were divided into groups based on left atrial appendage morphology (determined by computed tomography): the “chicken wing” group and the non–chicken wing group. We followed patients for more than 1 year to observe the incidence of stroke.
Results
Of 509 patients with a mean (SD) age of 48.9 (11.6) years; 332 (65.2%) were men. The chicken wing group had fewer left atrial appendage lobes, a lower left atrial appendage depth, and a smaller left atrial appendage orifice area (all P < .001). During the follow-up period, 5 of the 133 patients (3.8%) in the chicken wing group and 56 of the 376 patients (14.9%) in the non–chicken wing group experienced ischemic stroke (P < .001). The following findings were significantly associated with the incidence of stroke: left atrial appendage depth (hazard ratio [HR], 1.98; 95% CI, 1.67-3.12; P = .03), left atrial appendage orifice area (HR, 2.16; 95% CI, 1.59–3.13; P < .001), and non–chicken wing left atrial appendage morphology (HR, 1.16; 95% CI, 1.10–1.23; P < .001).
Conclusion
For patients with atrial fibrillation and a low CHA2DS2-VASc score, the non–chicken wing left atrial appendage morphology type is independently associated with ischemic stroke.
Publisher
Texas Heart Institute Journal
Subject
Cardiology and Cardiovascular Medicine
Cited by
4 articles.
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