Prevalence and prediction of left atrial thrombus in patients with a recent cerebral ischemic event, who are in sinus rhythm: a single-center experience.
BACKGROUND
Left atrial thrombus (LAT) is frequently present in patients with cerebral ischemic events (CIE) who are in atrial fibrillation. The prevalence and predictor of LAT in patients who are in sinus rhythm (SR) is unclear.


OBJECTIVE
To determine the prevalence and identify predictors of LAT formation in patients with CIE who are in SR.


METHODS
Consecutive patients with CIE who are in SR were evaluated by transesophageal echocardiography (TEE) from July 2000 to August 2001. Patient demographics including cerebrovascular risk factors were recorded.


RESULTS
LAT was present in 5.5%. Left ventricular systolic dysfunction (LVSD) was present in 25 (10%). Patients' mean age was 59 +/- 14 years and 119 (50%) were male. In the univariate analysis, LAT was associated with LVSD (odds ratio [OR] 9.24, 95% confidence interval [CI] 2.8; 10.3) and male patients (OR 4.56, 95% CI: 1.6, 12.6) who had coronary artery disease (OR 3.4, 95% CI: 1.3, 8.4). In the multivariate analysis, LVSD (OR 10.6, CI 2.2-51.6) strongly predicted the development of LAT.


CONCLUSIONS
LAT is not uncommon in patients CIE, who are in sinus rhythm, especially those with poor left ventricular functions. TEE should be considered in patients with CIE and LVSD for early detection and treatment of LAT.
Yahia
Abutaher M
AM
Department of Neurology, Neurosurgery & Radiology, Upstate Medical University, Syracuse, NY 13210, USA. lodiy@upstate.edu
Shaukat
Aasma
A
Kirmani
Jawad F
JF
Latorre
Julius Gene
JG
Qureshi
Adnan I
AI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology*; D002545:Brain Ischemia / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000453:epidemiology; D005260:Female; D005544:Forecasting; D007839:Functional Laterality; D006325:Heart Atria; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012727:Sex Characteristics; D013599:Systole; D013927:Thrombosis / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult