Hemoglobin A1c and risk of left atrial thrombus and spontaneous echo contrast in non-valvular atrial fibrillation patients

Eur J Med Res. 2017 Apr 21;22(1):15. doi: 10.1186/s40001-017-0257-x.

Abstract

Objectives: To evaluate the relationship between hemoglobin A1c (HbA1c) and risk of left atrial thrombus/spontaneous echo contrast (LAT/SEC) in non-valvular atrial fibrillation (AF) patients.

Methods: In this retrospective study, 1158 consecutive non-valvular AF patients undergoing transesophageal echocardiography prior to radiofrequency catheter ablation or electric cardioversion were enrolled. Baseline characteristics were collected and analyzed.

Results: There were 87 (7.5%) patients with LAT/SEC. The HbA1c levels in the patients with LAT/SEC were significantly higher than that in patients without LAT/SEC (6.13 ± 0.41 vs. 5.89 ± 0.45 μmol/L, P < 0.001). The optimal cut-off point for HbA1c predicting LAT/SEC was 6.1% determined by receiver-operating characteristic curve. The area under the curve is 0.788 (95% confidence interval: 0.764-0.812). HbA1c ≥6.1% was an independent risk factor for LAT/SEC (odds ratio, 1.74; 95% confidence interval, 1.01-2.98; P = 0.045).

Conclusions: Elevated HbA1c indicated a significantly increased risk for LAT/SEC in non-valvular AF patients. HbA1c might have significance in predicting the risk for prothrombotic state in non-valvular AF patients.

Keywords: Atrial fibrillation; Hemoglobin A1c; Left atrial thrombus; Prothrombotic state; Spontaneous echo contrast.

MeSH terms

  • Aged
  • Atrial Fibrillation / blood*
  • Atrial Fibrillation / physiopathology
  • Catheter Ablation / methods
  • Contrast Media / therapeutic use
  • Echocardiography, Transesophageal / methods
  • Female
  • Glycated Hemoglobin / metabolism*
  • Heart Atria / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Thrombosis / blood*
  • Thrombosis / physiopathology

Substances

  • Contrast Media
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human