Abstract 2655: Elevated C-reactive Protein is Associated With Left Atrial Appendage Thrombus in Patients With Non-valvular Atrial Fibrillation
Background. The pathogenesis of thrombus formation in atrial fibrillation (AF) is not solely related to stasis in a poorly contractile left atrium, and the presence of a hypercoagulable state could play some roles. Coagulation cascade and inflammatory molecules work as partners during thrombotic and inflammatory process. However it is still unknown whether inflammation is associated with left atrial appendage (LAA) thrombus formation in AF.
Methods and Results. We enrolled consecutive 338 patients with non-valvular, paroxysmal or persistent AF who underwent transesophageal echocardiography (TEE) examination. Patients with acute myocardial infarction, infectious disease, autoimmune disease or other inflammatory disease were excluded. We measured C-reactive protein (CRP) and counted white blood cells (WBC) within 7 days before or after TEE study. LAA thrombi were observed in 24 patients (7.1%) on TEE, and they had significant higher CRP level and WBC counts than those without thrombi. Multivariate logistic regression analysis demonstrated that CRP level is an independent predictor for LAA thrombi among clinical factors along with persistence of AF and absence of lone AF, while WBC was not selected as a risk factor.
Conclusion. Elevated CRP level was associated the risk of LAA thrombus in patients with non-valvular AF. Inflammatory process could play some roles in thrombogenesis within LAA in AF.