The relationship between left atrial thrombus and hematological markers in patients with chronic non-rheumatic atrial fibrillation

Abstract

We examined the relationship between left atrial thrombus and hematological variables in patients with chronic non-rheumatic atrial fibrillation (NRAf). This study consisted of 122 patients, 76 men and 46 women with a mean age of 73. Transesophageal echocardiography was performed to detect left atrial thrombi, and at the same time hematological variables including hematocrit, platelet count, fibrinogen level, thrombin-antithrombin III complex (TAT), D-dimer (DD) and fibrin degradation product E (FDP-E) levels were measured. Left atrial thrombi were detected in 28 (23%) of the 122 chronic NRAf patients. The serum fibrinogen was significantly higher in thrombus-positive patients than thrombus-negative patients (400 +/- 140 mg/dl vs. 274 +/- 69 mg/dl, p < 0.0001). The patients with left atrial thrombi had significantly higher levels of serum DD (302 +/- 200 vs. 157 +/- 101 ng/ml, p < 0.0001) and FDP-E (169 +/- 129 vs. 85 +/- 68 ng/ml, p < 0.0001) than the patients without. Scoring was made based on the levels of fibrinogen, DD and FDP-E as follows: 0 points if fibrinogen was under 380 mg/dl and 1 points if was 380 mg/dl or over, 0 points if DD was under 150 ng/ml, 1 points if 150 ng/ml or over and under 250 ng/ml, 2 points if 250 ng/ml or over, 0 points if FDP-E was under 70 ng/ml, 1 points if 70 ng/ml or over and under 140 ng/ml, 2 points if 140 ng/ml or over. According to the combined scores for these 3 markers, the prevalence of positive left atrial thrombi was 4% in 46 patients with 0 points, 18% in 38 patients with 1 or 2 points, 38% in 26 patients with 3 or 4 points and 75% in 12 patients with 5 points.