Predictive Value of Residual Cholesterol Inflammatory Index for Left Atrial Thrombus or Spontaneous Echo Contrast in Patients with Nonvalvular Atrial Fibrillation with Low CHA2DS2-VASc Scores

Jiaqi Wang,1,2 Yaqiong Jin,2 Li Wang,2 Yunmeng Wang,1,2 Jingchao Lu2 1Department of Graduate, Hebei Medical University, Shijiazhuang, People’s Republic of China; 2Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of ChinaCorrespondence: Jingchao Lu, Department of Cardiology, The Second Hospital of Hebei Medical University, 215 Hepingxi Road, Shijiazhuang, Hebei, 050000, People’s Republic of China, Email [email protected]: Left atrial thrombus (LAT) is the main cause of ischemic stroke in patients with atrial fibrillation. Left atrial thrombus or spontaneous echo contrast (SEC) can be best displayed by transesophageal echocardiography (TEE). This study aimed to evaluate non-valvular atrial fibrillation (NVAF) patients with LAT/SEC confirmed by transesophageal echocardiography compared with those without LAT/SEC, using residual cholesterol inflammatory index (RCII) as a sensitive biomarker.Methods: This study was a retrospective study of 967 NVAF patients who underwent transesophageal echocardiography at a single center. Patients were divided into two groups based on the presence or absence of LAT/SEC on TEE. The levels of RCII and left atrium diameter (LAD) were compared.Results: RCII was identified as an independent variable in patients with LAT/SEC detected by transesophageal echocardiography. (OR: 1.232, CI:1.159– 1.309, p < 0.001) The combination of RCII, LAD, and CHA2DS2-VASc scores had the highest area under the curve (AUC) value (AUC:0.787 CI:0.748– 0.826 p < 0.001).Conclusion: Our study demonstrates that RCII and LAD are risk factors for LAT/SEC. CHA2DS2-VASc score combined with RCII and LAD can significantly improve the predictive ability of LAT/SEC.Keywords: nonvalvular atrial fibrillation, left atrial thrombus, spontaneous echo contrast, residual cholesterol inflammatory index, transesophageal echocardiography