BACKGROUND AND PURPOSE Left atrial or left atrial appendage (LA/LAA) thrombi are frequently observed during cardioembolic evaluation in patients with ischemic stroke. This study aimed to investigate stroke outcomes in patients with LA/LAA thrombus. METHODS This retrospective study included patients admitted to a single tertiary center in Korea between January 2012 and December 2020. Patients with nonvalvular atrial fibrillation who underwent transesophageal echocardiography or multi-detector coronary computed tomography were included in the study. Poor outcome was defined as modified Rankin Scale score >3 at 90 days. The inverse probability of treatment weighting analysis was performed. RESULTS Of the 631 patients included in this study, 68 (10.7%) had LA/LAA thrombi. Patients were likely to have a poor outcome when an LA/LAA thrombus was detected (42.6% vs. 17.4%, P<0.001). Inverse probability of treatment weighting analysis yielded a higher probability of poor outcomes in patients with LA/LAA thrombus than in those without LA/LAA thrombus (P<0.001). Patients with LA/LAA thrombus were more likely to have relevant arterial occlusion on angiography (36.3% vs. 22.4%, P=0.047) and a longer hospital stay (8 vs. 7 days, P<0.001) than those without LA/LAA thrombus. However, there was no difference in early neurological deterioration during hospitalization or major adverse cardiovascular events within 3 months between the two groups. CONCLUSIONS Patients with ischemic stroke who had an LA/LAA thrombus were at risk of a worse functional outcome after 3 months, which was associated with relevant arterial occlusion and prolonged hospital stay.

中文翻译：

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左心房或左心耳血栓对中风结果的影响：匹配对照分析。

背景和目的 左心房或左心耳 (LA/LAA) 血栓在缺血性卒中患者的心脏栓塞评估中经常被观察到。本研究旨在调查 LA/LAA 血栓患者的卒中结局。方法 这项回顾性研究纳入了 2012 年 1 月至 2020 年 12 月期间在韩国一家三级中心收治的患者。接受经食管超声心动图或多排冠状动脉计算机断层扫描的非瓣膜性心房颤动患者被纳入研究。不良结果定义为 90 天时改良 Rankin 量表评分 >3。进行了治疗加权分析的逆概率。结果 在纳入本研究的 631 名患者中，68 名 (10.7%) 患有 LA/LAA 血栓。当检测到 LA/LAA 血栓时，患者的预后可能较差（42.6% 对 17.4%，P<0.001）。治疗加权逆概率分析表明，与没有 LA/LAA 血栓的患者相比，有 LA/LAA 血栓的患者出现不良结局的概率更高 (P<0.001)。与没有 LA/LAA 的患者相比，有 LA/LAA 血栓的患者在血管造影中更容易出现相关的动脉闭塞（36.3% vs. 22.4%，P=0.047）和更长的住院时间（8 vs. 7 天，P<0.001）血栓。然而，两组在住院期间早期神经功能恶化或 3 个月内发生主要不良心血管事件方面没有差异。结论 有 LA/LAA 血栓的缺血性卒中患者在 3 个月后有功能预后较差的风险，