Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
J Thromb Thrombolysis. 2024 Feb;57(2):269-277. doi: 10.1007/s11239-023-02917-4. Epub 2023 Nov 28.
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.
心房颤动（AF）是中风和全身性栓塞的独立危险因素。心源性和主动脉源性栓子是中风或全身性栓塞的原因。非阻塞性全血管镜检查（NOGA）可用于诊断主动脉内膜病变，包括血栓和动脉粥样硬化斑块，但关于 AF 患者的 NOGA 衍生主动脉内膜病变知之甚少。本研究侧重于 AF 患者的主动脉内膜病变，并评估了 AF 与使用 NOGA 检测到的主动脉血栓之间的关系。我们纳入了 283 例连续接受冠状动脉造影的冠心病患者，这些患者在 2017 年 1 月至 2022 年 8 月期间接受了主动脉的 NOGA。在冠状动脉造影后使用 NOGA 筛选主动脉内膜病变。根据 AF 病史（AF 组，n=50；非 AF 组，n=233）将患者分为两组。AF 组患者年龄大于非 AF 组。两组患者的性别、体重指数和冠状动脉危险因素无显著差异。在 NOGA 结果中，两组之间强烈黄色斑块和破裂斑块的存在没有显著差异。AF 组的主动脉血栓比非 AF 组更常见（92.0%比 71.6%，p<0.001）。多变量逻辑回归发现，AF 与主动脉血栓独立相关（优势比 3.87[95%CI 1.28-11.6]，p=0.016）。使用 NOGA 观察到的主动脉血栓与冠心病患者的 AF 有关。主动脉血栓的作用以及心源性栓塞可能需要进一步阐明。
