PMID- 25638519 OWN - NLM STAT- MEDLINE DCOM- 20150515 LR - 20220317 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 115 IP - 6 DP - 2015 Mar 15 TI - Relation of atrial fibrillation and right-sided cardiac thrombus to outcomes in patients with acute pulmonary embolism. PG - 825-30 LID - S0002-9149(14)02331-5 [pii] LID - 10.1016/j.amjcard.2014.12.049 [doi] AB - Atrial fibrillation (AF) can induce a hypercoagulable state in both the left and right atria. Thrombus in the right side of the heart (RHT) may lead to acute pulmonary embolism (APE). The aim of the study was to determine the prevalence of RHT and AF and to assess their impact on outcomes in patients with APE. The retrospective cohort included 1,006 patients (598 female), with a mean age of 66 +/- 15 years. The primary end point was all-cause mortality. The secondary end point was incidence of complications (death, cardiogenic shock, cardiac arrest, vasopressor/inotrope treatment, or ventilatory support). Atrial fibrillation was detected in 231 patients (24%). RHT was observed in 50 patients (5%). The combination of AF and RHT was observed in 16 patients (2%). The overall mortality rate was significantly higher in patients with RHT compared with those without (32% vs 14%, respectively, odds ratio [OR] 3.0, 95% confidence interval [CI] 1.6 to 5.6, p = 0.001). The rate of complications was significantly higher in patients with RHT in comparison to those without (40% vs 22%, respectively, OR 2.4, 95% CI 1.3 to 4.4, p = 0.004). The mortality rate in patients with both AF and RHT was significantly higher in comparison to those with AF but without RHT (50% vs 20%, respectively, OR 3.86, 95% CI 1.3 to 11.2, p = 0.01). In multivariate analysis, RHT (p = 0.03) was an independent predictor of death. In conclusion, AF is a frequent co-morbidity in patients with APE, and the presence of RHT is not uncommon. Among patients with APE, the presence of RHT increases the mortality approximately threefold regardless of the presence of known AF. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Kukla, Piotr AU - Kukla P AD - Department of Internal Medicine and Cardiology, Specialistic Hospital, Gorlice, Poland. Electronic address: kukla_piotr@poczta.onet.pl. FAU - McIntyre, Wiliam F AU - McIntyre WF AD - Section of Cardiology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. FAU - Koracevic, Goran AU - Koracevic G AD - Department for Cardiovascular Diseases, Clinical Center, Nis, Serbia. FAU - Kutlesic-Kurtovic, Dusanka AU - Kutlesic-Kurtovic D AD - Department for Cardiovascular Diseases, Clinical Center, Nis, Serbia. FAU - Fijorek, Kamil AU - Fijorek K AD - Department of Statistics, Cracow University of Economics, Cracow, Poland. FAU - Atanaskovic, Vesna AU - Atanaskovic V AD - Department for Cardiovascular Diseases, Clinical Center, Nis, Serbia. FAU - Krupa, Ewa AU - Krupa E AD - Department of Cardiology, Szczeklik Specialistic Hospital, Tarnow, Poland. FAU - Mirek-Bryniarska, Ewa AU - Mirek-Bryniarska E AD - Department of Cardiology, Dietl Specialistic Hospital, Cracow, Poland. FAU - Jastrzebski, Marek AU - Jastrzebski M AD - First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Cracow, Poland. FAU - Bryniarski, Leszek AU - Bryniarski L AD - First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Cracow, Poland. FAU - Pruszczyk, Piotr AU - Pruszczyk P AD - Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland. FAU - Baranchuk, Adrian AU - Baranchuk A AD - Division of Cardiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20150106 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Acute Disease MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Atrial Fibrillation/*complications/diagnosis/*epidemiology/mortality MH - Canada/epidemiology MH - Female MH - *Heart Atria/pathology MH - Humans MH - Incidence MH - Inpatients MH - Male MH - Middle Aged MH - Poland/epidemiology MH - Prevalence MH - Prognosis MH - Pulmonary Embolism/diagnosis/*epidemiology/*etiology/mortality MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Survival Rate MH - Thrombosis/*complications/mortality EDAT- 2015/02/02 06:00 MHDA- 2015/05/16 06:00 CRDT- 2015/02/02 06:00 PHST- 2014/10/29 00:00 [received] PHST- 2014/12/23 00:00 [revised] PHST- 2014/12/23 00:00 [accepted] PHST- 2015/02/02 06:00 [entrez] PHST- 2015/02/02 06:00 [pubmed] PHST- 2015/05/16 06:00 [medline] AID - S0002-9149(14)02331-5 [pii] AID - 10.1016/j.amjcard.2014.12.049 [doi] PST - ppublish SO - Am J Cardiol. 2015 Mar 15;115(6):825-30. doi: 10.1016/j.amjcard.2014.12.049. Epub 2015 Jan 6.