The Role of triggering receptor expressed on myeloid cells (TREM) like transcript-1 (TLT-1) in left atrial spontaneous echo contrast in patients with non-valvular atrial fibrillation

Objectives Trigger receptor expressed on myeloid cells(TREM) like transcript-1 (TLT-1) is present in megakaryocytes and platelets. We assessed levels of membrane and soluble TLT-1 in patients with nonvalvular atrial fibrillation (NVAF) to confirm the role of TLT-1 left atrial spontaneous echo contrast (LASEC) in atrial fibrillation. Methods A total of 113 NVAF patients underwent transesophageal echocardiography (TEE) were enrolled and divided into non LASEC group (n = 78) and LASEC group (n = 35). Patients with supraventricular tachycardia and health examinees were served as control (n = 50).TLT-1 and soluble TLT-1 levels of all subjects were determined using flow cytometry and enzyme-linked immunosorbent (ELISA) assay. The risk factors for LASEC were assessed by logistic regression analyses. Results Expressions of TLT-1 and plasma sTLT-1 in platelet and plasma were increased in LASEC group, compared to non LASEC group. At receiver operating characteristic curve analysis, TLT-1 and sTLT-1 significantly predicted the risk of LASEC (AUC, 0.708, 0.662).Multivariate logistic regression model showed that N-terminal pro-brain natriuretic peptide (NT-proBNP) and TLT-1 were independently associated with LASEC (1.00 (1.00–1.00), p =  0.004; 2.74 (1.05–7.11), p = 0.039 ). Conclusion Aberrant high expression of TLT-1 and NT-proBNP indicated the presence of LASEC in AF patients. TLT-1 could be a new useful predictor of LASEC in NVAF.