TY - JOUR
T1 - Atrial fibrillation is related to lower incidence of deep venous thrombosis in patients with pulmonary embolism
AU - Waleed, Khalid Bin
AU - Guan, Xumin
AU - Li, Xintao
AU - Yang, Yiheng
AU - Wang, Zhao
AU - Yin, Xiaomeng
AU - Wang, Zhengyan
AU - Liu, Jianghai
AU - Gao, Lianjun
AU - Chang, Dong
AU - Xiao, Xianjie
AU - Zhang, Rongfeng
AU - Tse, Gary
AU - Xia, Yunlong
N1 - Publisher Copyright:
© Journal of Thoracic Disease.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Background: Atrial fibrillation (AF) is an established risk factor of left atrial thrombosis and systemic embolism. Traditionally pulmonary embolism (PE) is a recognized complication of deep vein thrombosis (DVT). However, whether AF is responsible for right atrial thrombosis and leads to PE has not been examined. Methods: We retrospectively analyzed medical records of patients with confirmed diagnosis of PE with AF (study group) from 2002-2015. Patients with PE without AF, matched by age and sex, served as controls (control group). The CHA2DS2-VASc and CHADS2 scores were classified into two categories, lowintermediate ( < 2 points) and high-risk (≥2 points). Results: A total of 330 patients (110 in study group and 220 in control group). The study group had significantly lower incidence of newly diagnosed DVT (21% vs. 44%, P < 0.001), previous history of DVT (6% vs. 17%, P=0.006) and recent surgery or trauma (10% vs. 23%, P=0.004) compared to the control group. When stratified by the CHADS2 score, 49 patients (44.5%) were considered low-intermediate risk. This proportion significantly differed when stratified using CHA2DS2-VASc, in which 13 patients (13.6%) were considered low-intermediate risk, P<0.001. Conclusions: The incidence of DVT was much lower in the study group, suggesting the possibility of clots originated from the right heart that may increase the risk of PE. The CHA2DS2-VASc scoring system might be more sensitive for prediction and stratification of the PE in AF patients than the CHADS2 score.
AB - Background: Atrial fibrillation (AF) is an established risk factor of left atrial thrombosis and systemic embolism. Traditionally pulmonary embolism (PE) is a recognized complication of deep vein thrombosis (DVT). However, whether AF is responsible for right atrial thrombosis and leads to PE has not been examined. Methods: We retrospectively analyzed medical records of patients with confirmed diagnosis of PE with AF (study group) from 2002-2015. Patients with PE without AF, matched by age and sex, served as controls (control group). The CHA2DS2-VASc and CHADS2 scores were classified into two categories, lowintermediate ( < 2 points) and high-risk (≥2 points). Results: A total of 330 patients (110 in study group and 220 in control group). The study group had significantly lower incidence of newly diagnosed DVT (21% vs. 44%, P < 0.001), previous history of DVT (6% vs. 17%, P=0.006) and recent surgery or trauma (10% vs. 23%, P=0.004) compared to the control group. When stratified by the CHADS2 score, 49 patients (44.5%) were considered low-intermediate risk. This proportion significantly differed when stratified using CHA2DS2-VASc, in which 13 patients (13.6%) were considered low-intermediate risk, P<0.001. Conclusions: The incidence of DVT was much lower in the study group, suggesting the possibility of clots originated from the right heart that may increase the risk of PE. The CHA2DS2-VASc scoring system might be more sensitive for prediction and stratification of the PE in AF patients than the CHADS2 score.
KW - Atrial fibrillation (AF)
KW - CHADS score
KW - CHADS-VASc score
KW - Deep vein thrombosis (DVT)
KW - Pulmonary embolism (PE)
UR - https://www.scopus.com/pages/publications/85045265322
U2 - 10.21037/jtd.2018.01.177
DO - 10.21037/jtd.2018.01.177
M3 - Article
AN - SCOPUS:85045265322
SN - 2072-1439
VL - 10
SP - 1476
EP - 1482
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
IS - 3
ER -