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Association between aortic thrombi detected using non-obstructive general angioscopy and atrial fibrillation

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Abstract

Atrial fibrillation (AF) is an independent risk factor for stroke and systemic embolism. Cardiogenic and aortogenic emboli are causes of stroke or systemic embolism. Non-obstructive general angioscopy (NOGA) can be used to diagnose aortic intimal findings, including thrombi and atherosclerotic plaques, but little is known about NOGA-derived aortic intimal findings in patients with AF. This study focused on aortic intimal findings in patients with AF and evaluated the association between AF and aortic thrombi detected using NOGA. We enrolled 283 consecutive patients with coronary artery disease who underwent NOGA of the aorta between January 2017 and August 2022. Aortic intimal findings were screened using NOGA after coronary arteriography. The patients were divided into two groups according to their AF history (AF, n = 50 and non-AF, n = 233). Patients in the AF group were older than those in the non-AF group. Sex, body mass index, and coronary risk factors were not significantly different between the two groups. In the NOGA findings, the presence of intense yellow plaques and ruptured plaques was not significantly different between the two groups. Aortic thrombi were more frequent in the AF group than in the non-AF group (92.0 vs. 71.6%, p < 0.001). Multivariate logistic regression found that AF was independently associated with aortic thrombi (odds ratio 3.87 [95% CI 1.28–11.6], p = 0.016). The presence of aortic thrombi observed using NOGA was associated with AF in patients with coronary artery disease. The roles of aortic thrombi as well as cardiogenic embolism may require clarification.

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Funding

This work was supported by JSPS KAKENHI Grant Number 21K16041.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan

    Saki Mizobuchi, Keisuke Kojima, Masatsugu Miyagawa, Yudai Tanaka, Shohei Migita, Katsunori Fukumoto, Yutaka Koyama, Yasunari Ebuchi, Kurara Takahashi, Yuki Nakajima, Riku Arai, Nobuhiro Murata, Daisuke Fukamachi & Yasuo Okumura

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  1. Saki Mizobuchi
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Correspondence to Keisuke Kojima.

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The following authors have potential conflicts of interest: Dr. Okumura has received research funding from Bayer Healthcare, Daiichi-Sankyo, Bristol-Meyers Squibb, Nippon Boehringer Ingelheim, Pfizer, and Boston Scientific Japan and has accepted remuneration from Bayer Healthcare, Daiichi-Sankyo, and Bristol-Meyers Squibb. The other authors have no conflict of interest.

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Mizobuchi, S., Kojima, K., Miyagawa, M. et al. Association between aortic thrombi detected using non-obstructive general angioscopy and atrial fibrillation. J Thromb Thrombolysis 57, 269–277 (2024). https://doi.org/10.1007/s11239-023-02917-4

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