title: Systemic inflammation and left atrial thrombus in patients with non-rheumatic atrial fibrillation.
abstract: BACKGROUND
  There is an apparent link between thrombogenesis and inflammation. We hypothesized that systemic inflammation [as indicated by C-reactive protein (CRP)] would be related to the presence of left atrial (LA) thrombus in patients with atrial fibrillation (AF). To test this hypothesis, we evaluated the relationship between CRP and LA thrombus in patients with non-rheumatic AF.
  
  
  RESULTS
  Between October 2004 and December 2008, 190 patients with non-rheumatic AF (122 males, age 71+/-10 years) who underwent transesophageal echocardiography (TEE) were enrolled and analyzed. All patients were examined for presence or absence of LA thrombus by TEE. CRP was measured within 1 week before the TEE examination. LA thrombus was detected in 19 patients (10%). Hypertension, hypertensive heart disease (HHD), valvular heart disease, ticlopidine, and CRP were univariate correlates of LA thrombus. By multivariate analysis, HHD (p<0.01), ticlopidine (p=0.01), and CRP (p=0.03) were independently associated with LA thrombus. A cut-off CRP value for identifying LA thrombus was 0.21mg/dl (sensitivity: 84%, specificity: 60%, positive predictive value: 19%, and negative predictive value: 97%).
  
  
  CONCLUSIONS
  A high CRP is related to LA thrombus in patients with non-rheumatic AF.
authors.affiliation: Department of Cardiology, Kawasaki Medical School, Matsushima 577, Kurashiki, Okayama 701-0192, Japan. tmaehama@med.kawasaki-m.ac.jp
authors.forename: Tomoko
authors.initials: T
authors.lastname: Maehama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Imai
authors.forename: Ken
authors.initials: K
authors.lastname: Saito
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Yamada
authors.forename: Terumasa
authors.initials: T
authors.lastname: Koyama
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hayashida
authors.forename: Yoji
authors.initials: Y
authors.lastname: Neishi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kawamoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D002097:C-Reactive Protein / Q000032:analysis; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000473:pathology*
chemical_list: D002097:C-Reactive Protein