| Atrial fibrillation - patients at high risk for cerebral embolism. | |
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MedLine Citation:
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PMID: 16598527 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Patients with atrial fibrillation (AF) have a risk of cerebral embolism. Echocardiographic parameters elevate this risk significantly. However, there is little knowledge about the long-term fate and the rate of clinically silent cerebral embolism under continued oral anticoagulation. The aims of our study were to assess prognosis of patients with AF and determine a high risk group with an increased risk of cerebral embolism under oral anticoagulation. METHODS: Consecutive patients with persistent or permanent AF and left atrial (LA) thrombi, dense spontaneous echo contrast (SEC) and/or reduced LA appendage peak emptying velocities (LAAv) were included in the study (N = 128). Patients with AF and without echocardiographic risk factors (N = 114) served as controls. All patients were examined with transesophageal echocardiography, cranial magnetic resonance imaging and clinically during a period of three years. RESULTS: During the three-year follow-up period 6 (5%) of the high risk patients had cerebral embolism with neurological deficits. 4 (3%) patients died due to embolic events and 17 (13%) patients had silent embolism as documented on MRI. In the control group 8 (7%) patients had embolic events (n = 1 clinically apparent and n = 7 silent embolism) documented on MRI, one was clinically apparent. Study patients with an event had more commonly previous thromboembolism (p < 0.0001). CONCLUSIONS: Patients with peristent or permanent AF and LA thrombi, dense SEC or reduced LAAv have an explicitly increased risk of cerebral embolism (21%) despite oral anticoagulation. Previous thromboembolic event is another important predictor for an event. |
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Authors:
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P Bernhardt; H Schmidt; T Sommer; B Lüderitz; H Omran |
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Publication Detail:
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Type: Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2006-01-12 |
Journal Detail:
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Title: Clinical research in cardiology : official journal of the German Cardiac Society Volume: 95 ISSN: 1861-0684 ISO Abbreviation: - Publication Date: 2006 Mar |
Date Detail:
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Created Date: 2006-04-06 Completed Date: 2006-05-10 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 101264123 Medline TA: Clin Res Cardiol Country: Germany |
Other Details:
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Languages: eng Pagination: 148-53 Citation Subset: IM |
Affiliation:
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Department of Medicine-Cardiology, University of Bonn, Germany. bernhardt@cardiovasc-mri.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Fibrillation
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epidemiology*,
ultrasonography* Comorbidity Echocardiography, Transesophageal / statistics & numerical data Female Germany Humans Incidence Intracranial Embolism / diagnosis*, epidemiology* Magnetic Resonance Imaging / statistics & numerical data Male Middle Aged Risk Assessment / methods* Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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