Background: Compared to whites and Hispanics, African Americans (AA) have increased levels of fibrinogen and other hemostatic factors. Whether this affects thrombogenic milieu in the left atrial appendage (LAA) of patients with nonvalvular atrial fibrillation (NVAF) is unknown. Methods: We evaluated the LAA of 234 patients (66 ± 12 years, 190 [81%] men, 122 [52%] whites, 77 [33%] Hispanics and 35 [15%] AA) with NVAF undergoing transesophageal echocardiography for smoke or sludge and measured LAA emptying velocity. Left ventricular ejection fraction (LVEF) and left atrial diameter were determined from transthoracic echocardiography. We recorded thromboembolic risk factors including hypertension, diabetes, stroke, heart failure, (HF), vascular disease and glomerular filtration rate. We compared these variables in AA and non-AA and evaluated predictors of smoke and sludge. Results: AA were younger and had lower LVEF and a higher prevalence of HF, smoke and sludge compared to non-AA. There were no other statistically significant differences between the groups (Table 1). After adjusting for variables with p < 0.20 in univariate analysis, AA ethnicity remained an independent predictor of LAA smoke (OR = 3.0, 95% CI = 1.3 - 7.2, p = 0.012) and sludge (OR = 4.9, 95% CI = 1.8 - 13.0, p = 0.002). Conclusion: AA ethnicity is an independent predictor of thrombogenic milieu in NVAF. Further studies are needed to determine whether risk scores and intensity of anticoagulation in NVAF need to be adjusted for ethnicity. (Table Presented).
Willens, H. J., Gomez-Marin, O., DeNicco, A., Gonzalez, J. F. V., Coffey, J. O., & Mitrani, R. (2014). RELATIONSHIP OF ETHNICITY TO LEFT ATRIAL APPENDAGE THROMBOGENIC MILIEU IN NONVALVULAR ATRIAL FIBRILLATION. Journal of the American College of Cardiology, 63(12), A355. https://doi.org/10.1016/s0735-1097(14)60355-7