High-density lipoprotein cholesterol and left atrial or left atrial appendage thrombus in non-valvular atrial fibrillation patients

Cui, Lijun; Li-ju, Han; Zhao, Li; Ma, Juncheng; Ma, Xiaojie; Zhou, Chunyuan; Li, Guangping

doi:10.1016/j.ijcme.2015.01.001

Cited by 1 publication

(2 citation statements)

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“…Gunawardene et al reported that LAA thrombus was found in 7.1% (2/28) of the patients with AF and HCM by TEE before catheter ablation, but was found in only 0.7% (11/1630) of patients with AF without HCM (7). Another study enrolled a large sample of 205 Asian patients with HCM and AF who had undergone TEE before cardioversion or catheter ablation (8). LAA thrombus was found in 10.7% (22/205) of the patients with HCM.…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous left atrial appendage closure (LAAC), especially with WATCHMAN device, has been demonstrated in randomized trials to reduce stroke and therefore can be an alternative to warfarin therapy for stroke prevention in the general AF population (5,6). The efficacy of LAAC for stroke prevention in patients with HCM and AF, however, has not been studied, although the incidences of left atrial appendage (LAA) thrombus in this subpopulation has been reported to be 7.1-10.7% (7,8). Therefore, the aim of this pilot study was to evaluate the efficacy of LAAC in patients with HCM and AF for primary and secondary stroke prevention.…”

Section: Introductionmentioning

confidence: 99%

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Left Atrial Appendage Closure for Primary and Secondary Stroke Prevention in Patients With Hypertrophic Cardiomyopathy and Atrial Fibrillation: A Pilot Study

Zhang

Yuan

et al. 2021

Front. Cardiovasc. Med.

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Background: The aim of this study was to investigate the efficacy of left atrial appendage closure (LAAC) for primary and secondary stroke prevention in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF).Methods: This pilot study enrolled 36 patients with HCM and AF who underwent LAAC between April 2017 and December 2019, of whom 22 were for primary stroke prevention and 14 were for secondary prevention.Results: The patients enrolled in this study had non-obstructive (86.1%) or mild obstructive (13.9%) HCM. Patients in the Secondary Prevention Group had higher CHA2DS2-VASc scores (5.1 ± 1.4 vs. 2.6 ± 1.6, P < 0.001) and higher HAS-BLED scores (2.8 ± 1.0 vs. 1.5 ± 0.9, P < 0.001) compared with those in the Primary Prevention Group. Successful closure with satisfactory seals (residual leak ≤ 5 mm) was achieved in all patients, with complete occlusion in 86.4% of the Primary Prevention Group and 92.9% of the Secondary Prevention Group. Procedural-related complications included one pericardial effusion and one groin hematoma. One device-related thrombus was identified in the Secondary Prevention Group and resolved after anticoagulation. During a mean follow-up time of 28.4 months, one bleeding event was recorded. There were no thromboembolic events or deaths in either group, with 97.2% of the patients achieving freedom from anticoagulation therapy.Conclusions: Initial results suggest that LAAC can be a safe and feasible alternative for primary and secondary stroke prevention in selected patients with HCM and AF. Further studies with larger samples are required.

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Section: Discussionmentioning

confidence: 99%