title: Risk factors for embolism in cardiac myxoma: a retrospective analysis.
abstract: BACKGROUND
  Myxomas are the most common primary heart tumors and are closely associated with embolic events. Cardiac myxomas typically arise from the interatrial septum at the border of the fossa ovalis in the left atrium. Any other location is considered atypical. Embolism, one of the complications of myxoma, is associated with high morbidity and mortality. The aim of this study was to investigate the risk factors for embolism in patients with cardiac myxoma.
  
  
  METHODS
  In this retrospective study, a cohort of 162 patients with cardiac myxomas was surgically treated between January 1998 and June 2014 at 3 cardiac centers in China. Preoperative data, including platelet count, sex, age, and the tumor (size, location, surface, and attachment), were compared between embolic and non-embolic groups of patients.
  
  
  RESULTS
  No significant differences in vascular risk factors were seen between the 2 groups. However, the percentage of higher platelet count (>300 × 10(9)/L) and mean platelet volume in the embolic group were significantly higher than in the non-embolic group (P=0.0356, and 0.0113, respectively). Irregular surface and atypical location of the myxomas were also independently associated with increased risk of embolic complications.
  
  
  CONCLUSIONS
  Tumor location, macroscopic appearance, mean platelet volume, and high platelet count are strong risk factors for embolic events in patients with cardiac myxomas.
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China (mainland).
authors.forename: Deng-Ke
authors.initials: DK
authors.lastname: He
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China (mainland).
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Zhang
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China (mainland).
authors.forename: Yin
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Department of Cardiothoracic Surgery, Fuzhou General Hospital, Fuzhou, Fujian, China (mainland).
authors.forename: Shi-Xing
authors.initials: SX
authors.lastname: Ye
authors.affiliation: Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China (mainland).
authors.forename: Chong
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China (mainland).
authors.forename: Bo
authors.initials: B
authors.lastname: Kang
authors.affiliation: Department of Cardiothoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China (mainland).
authors.forename: Zhi-Nong
authors.initials: ZN
authors.lastname: Wang
mesh_terms: D000328:Adult; D003710:Demography; D004617:Embolism / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D006338:Heart Neoplasms / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D015999:Multivariate Analysis; D009232:Myxoma / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D010976:Platelet Count; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography