Hemoglobin A1c and risk of left atrial thrombus and spontaneous echo contrast in non-valvular atrial fibrillation patients

Kuang, Rong-Ren; Liu, Fang‐Zhou; Liu, Yunpeng; Lin, Weidong; Liang, Huasheng; Chen, Aihua

doi:10.1186/s40001-017-0257-x

Cited by 6 publications

(2 citation statements)

References 23 publications

(23 reference statements)

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“…Combined with comb-like structures of LAA, reduced LAAV is easy for thrombus formation. Ren [13] found that elevated HbA1c indicated a significantly increased risk for left atrial thrombus/spontaneous echo contrast in nonvalvular AF patients. Furthermore, LA/LAA thrombus is a potential source of thromboembolic events such as ischemic stroke.…”

Section: Discussionmentioning

confidence: 99%

Increased hemoglobin A1c level associates with low left atrial appendage flow velocity in patients of atrial fibrillation

Wei

Cui

Liu

et al. 2021

Nutrition, Metabolism and Cardiovascular Diseases

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Background and aims: High hemoglobin A1c (HbAlc) level is associated with increased cardiovascular disease risk and thromboembolic events [1]. The study sought to explored the association between HbAlc and left atrial appendage flow velocity (LAAV) among non-valvular atrial fibrillation (AF) patients. Methods and results: A total of 249 consecutive non-valvular AF patients who underwent transesophageal echocardiography (TEE) were divided into two subgroups according to the median of LAAV level (<45 cm/s, !45 cm/s). Blood samples and other baseline clinical data of all patients were collected and analyzed. The low LAAV group included 126 patients and the high LAAV group included 123 patients. Patients in the low LAAV group were older and had a higher percentage of persistent AF, chronic heart failure, and higher CHA2DS2-VASc score (P < 0.05). HbAlc level in the low LAAV group was significantly higher than the high LAAV group [6.1 (5.7e6.5)% vs 5.9 (5.6e6.2)%, P Z 0.010]. The low LAAV group had larger left atrial diameter (LAD), left atrial area (LAA), higher left atrial pressure (LAP), and lower left ventricular ejection fraction (LVEF) (P < 0.05). Spearman rank correlation analysis showed that the HbAlc level was negatively correlated with LAAV (r Z À0.211, P Z 0.001). Multivariate analysis indicated that female gender (OR Z 2.233, 95% CI 1.110e4.492, P Z 0.024), persistent AF (OR Z 6.610, 95% CI 3.109e14.052, P < 0.001), and HbAlc (OR Z 1.903, 95% CI 1.092e3.317, P Z 0.023) were independent factors that associated with low LAAV in AF patients. Conclusion: Increased HbAlc level is associated with decreased LAAV and may reflect a low contractile function of the left atrial appendage.

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Section: Discussionmentioning

confidence: 99%

Increased hemoglobin A1c level associates with low left atrial appendage flow velocity in patients of atrial fibrillation

Wei

Cui

Liu

et al. 2021

Nutrition, Metabolism and Cardiovascular Diseases

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show abstract

“…[4][5][6] Left atrial appendage is a significant thrombus formation source in more than 90% of patients with nonvalvular AF. [7][8][9] Left atrial appendage closure (LAAC) has been demonstrated as an important alternative to prevent stroke for AF patients, especially for those intolerant to oral anticoagulation drugs. 10,11 AF ablation provides relatively reliable rhythm control, and LAAC reduces the risk of stroke.…”

Section: Introductionmentioning

confidence: 99%

The long‐term efficacy and safety of combining ablation and left atrial appendage closure: A systematic review and meta‐analysis

Sun

et al. 2021

Cardiovasc electrophysiol

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Background: Combined ablation and left atrial appendage closure (LAAC) is an alternative for atrial fibrillation patients with a high risk of stroke. However, the long-term outcomes of this combined procedure remain elusive.Methods: PubMed, Embase, Cochrane Library, and Web of Science were systematically searched from the establishment of databases to 1 January 2021. Studies on the long-term (defined as a mean follow-up of approximately 12 months or longer) efficacy and safety outcomes of combined ablation and LAAC were included.Results: A total of 16 studies comprising 1428 patients were enrolled. The pooled long-term freedom rate from atrial arrhythmia was 0.66 (95% confidence interval[CI]: 0.59-0.71), long-term successful rate sealing of LAAC was 1.00 (95% CI:1.00-1.00), and ischemic stroke/transient ischemic attack/systemic embolism during follow-up was 0.01 (95% CI: 0.00-0.02). Meanwhile, of the periprocedural adverse events, phrenic nerve palsy, intracoronary air embolus, device embolization, and periprocedural death had a rate of 0.00 (95% CI: 0.00-0.00), procedure-related bleeding events of 0.03 (95% CI: 0.02-0.04), and pericardial effusion requiring or not requiring intervention of 0.00 (95% CI: 0.00-0.01). Moreover, for the long-term adverse events, device dislocation, intracranial bleeding, pericardial effusion requiring or not requiring intervention, and all-cause mortality had a rate of 0.00 (95% CI: 0.00-0.00), device embolization of 0.01 (95% CI: 0.00-0.01), and other bleeding events of 0.01 (95% CI: 0.00-0.03). Conclusion:This meta-analysis suggests that the combined atrial ablation and LAAC is an effective and safe strategy with long-term benefits.

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Mid-term outcomes of concomitant left atrial appendage closure and catheter ablation for non-valvular atrial fibrillation: a multicenter registry

et al. 2019

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Hemoglobin A1c and risk of left atrial thrombus and spontaneous echo contrast in non-valvular atrial fibrillation patients

Cited by 6 publications

References 23 publications

Increased hemoglobin A1c level associates with low left atrial appendage flow velocity in patients of atrial fibrillation

Increased hemoglobin A1c level associates with low left atrial appendage flow velocity in patients of atrial fibrillation

The long‐term efficacy and safety of combining ablation and left atrial appendage closure: A systematic review and meta‐analysis

Mid-term outcomes of concomitant left atrial appendage closure and catheter ablation for non-valvular atrial fibrillation: a multicenter registry

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