Abstract WP168: The Impact of Intracardiac Thrombi on Recurrent Ischemic Events in Acute Ischemic Stroke Patients With Non-valvular Atrial Fibrillation the Samurai-nvaf Study
Objective: The intracardiac thrombus is associated with an increase in the risks of stroke and thromboembolism for primary prevention. However, it remains unclear in the setting of early management of patients with acute ischemic stroke/TIA. The purpose of this study was to clarify the impact of intracardiac thrombi on recurrent ischemic events in acute ischemic stroke/TIA patients with nonvalvular atrial fibrillation (NVAF).
Methods: In the SAMURAI-NVAF study (an ongoing prospective, multicenter, observational study), 1192 acute ischemic stroke/TIA patients with NVAF were registered. Of these, the patients who underwent transesophageal echocardiography (TEE) and/or transthoracic echocardiography (TTE) during acute hospitalization were included. We evaluated the association between the prevalence of intracardiac thrombi and recurrent ischemic events (composite of ischemic stroke/TIA and systemic embolism) during hospital stay (median 29 days).
Results: A total of 1091 patients (474 women, 77.6±9.9 y.o) were studied. Of these, 48 patients had intracardiac thrombus (4.4% [95% CI, 3.3-5.7%]). In acute hospital stay, 29 recurrent ischemic events (2.7% [1.9-3.8%]; 24 ischemic stroke, 3 TIA, and 2 systemic embolism) occurred. Patients with intracardiac thrombi had higher incidence of recurrent ischemic events than those without (12.5% versus 2.2%, p<0.001). The thrombus was an independent predictor for ischemic events after adjusted for age, sex and platelet count (OR 6.5; 95% CI 2.28-16.36, p=0.002). Detectability of thrombi increased when only patients undergoing both TEE and TTE were studied (34/216, 16%).
Conclusion: In acute ischemic stroke/TIA patients with NVAF, intracardiac thrombi are associated with risk of recurrent ischemic events. The evaluation of intracardiac thrombus should be considered in acute phase of ischemic stroke/TIA.
Author Disclosures: N. Kinoshita: None. H. Yamagami: Honoraria; Modest; Bayer Yakuhin, Ltd, Nippon Boehringer Ingelheim Co., Ltd., Bristol-Myers Squibb, Pfizer Japan Inc., DAIICHI SANKYO Co., Ltd.. K. Todo: None. K. Kimura: None. E. Furui: None. T. Terasaki: None. Y. Shiokawa: None. K. Kamiyama: None. S. Takizawa: None. S. Okuda: None. Y. Okada: None. T. Kameda: None. Y. Nagakane: None. Y. Hasegawa: None. S. Shibuya: None. Y. Ito: None. T. Nakashima: None. K. Takamatsu: None. K. Nishiyama: None. Y. Yagita: None. K. Kario: None. K. Higashida: None. S. Yoshimura: Honoraria; Modest; Astellas Pharma Inc., Sanofi K.K.. S. Arihiro: None. M. Koga: Honoraria; Modest; Bayer Yakuhin, Ltd, Bristol Myers Squibb K.K., Nippon Boehringer Ingelheim Co.,Ltd. K. Nagatsuka: Honoraria; Modest; Bayer Yakuhin, Ltd, Boehringer Ingelheim GmbH, DAIICHI SANKYO Co., Ltd., Pfizer, Bristol-Myers Squibb. K. Toyoda: Honoraria; Modest; Bayer Yakuhin, Ltd., Bristol Myers Squibb K.K., Nippon Boehringer Ingelheim Co.,Ltd, Phizer.
- © 2016 by American Heart Association, Inc.