More specifically, among the 86 patients, 43 (50%) had NT-proBNP values above the respective cut-off and were considered as having AF of presumably recent onset (group A). Of these patients, only two (4.7%) were found to have a LA/LAA thrombus on TEE compared with 13 of 43 patients (30.2%) with NTproBNP levels below the cut-off value (group B, p=0.002; univariate OR 6.5 (95% CI 1.6 to 27.1) for a patient in group B versus a patient in group A to have a LA/LAA thrombus). The finding of NTproBNP levels above the cut-off value therefore had a 95.3% negative predictive value for the presence of thrombus. The two patients in group A who were found to have a LA/LAA thrombus despite the presumably recent onset of the arrhythmia had significantly enlarged atria (51 and 48 mm compared with a mean of 40.7±0.6 mm in group A) and a high CHA2DS2VASc score (4 and 8 compared with a mean of 1.5±0.2 in group A).
The association of NTproBNP stratification, as a putative indicator of time of onset, with the development of a thrombotic milieu was also evident in the detection of SEC in LA. Sixteen of the 43 patients in group B (37.2%) had SEC compared with 6 of 43 (14.0%) in group A (p=0.013; univariate OR 2.7). Of note, the presence of SEC was also associated with age (p=0.001), LA diameter (p<0.001) and CHA2DS2VASc score (p=0.003).
In the follow-up visit 23±3 days after discharge, all patients had NTproBNP levels below the respective cut-offs (mean values 198±20 and 158±18 for groups A and B, respectively; p=0.138).
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