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Background Atrial fibrillation (AF) is the most frequent arrhythmia with a high risk for thromboembolic events. The presence of left atrial appendage (LAA) thrombus is associated with a greater risk for stroke, yet few papers investgated predictor factors for LAA thrombus. Platelets indices-Mean platelet volume (MPV) and plateletcrit (PTC)-have been correlated with platelet reactivity, thrombogenicity and a high cardiovascular risk. Purpose The aim of this study is to determine if MPV-to-PCT and MPV-to-platelet (PLT) ratios could predict the presence of LAA thrombus in nonvalvular AF patients. Methods This retrospective study includes 112 patients screened with trans-esophageal echography (TEE) for LAA thrombus from January 2018 to Aprilie 2019. We excluded patients with manifest, deep vein thrombosis, pulmonary trombembolism and malignancies. The platelets indices were measured on admission. ROC curve analysis and the Youden index associated criterion was used to determine the cut-off values and Chi –square test to estimate associated risks. Results The focus group consisted of 112 AF patients, with a mean age of 67 ± 10.02 and 52.3% males. 71% patients had persistent AF, 19.64% (22) patients had LAA thrombi. Higher MPV-to-PCT, respectively MPV-to-PLT ratios were associated with LAA thrombus. In ROC curve analysis MPV-to-PLT ratio (AUC 0.618 95% CI 0.521 to 0.708, p = 0.0729) and MPV-to-PCT ratio (AUC 0.627, 95% CI 0.530 to 0.716, p = 0.05) predicted LAA thrombi, with a cut-off value of &amp;gt;38 for MPV-to-PCT and &amp;gt;0.049 for MPV-to-PLT ratio. Patients with an MPV-to-PCT ratio &amp;gt; 38 had a risk ratio of 1.21 (95% CI 1.03 - 1.44, p = 0.039) and those with an MPV-to-PLT ratio&amp;gt; 0.049 a risk ratio of 1.27 (95%CI 1.03 - 1.58, p = 0.01 ) of having a LAA thrombus. Conclusion Platelets indices are cost efficient, readily available thrombogenesis biomarkers that could be auxilliary parameters useful for the associtation of LAA thrombi in non-valvular AF patients undergoing TEE before cardioversion. We suggest the cut-off values of MPV-to-PCT&amp;gt; 38 and MPV-to-PLT &amp;gt; 0.049 to be considered as risk indicator.

P1376 The utility of platelets indices in predicting the presence of left atrial appendage thrombus in patients with atrial fibrillation