These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: NOACs and atrial fibrillation: Incidence and predictors of left atrial thrombus in the real world.
    Author: Bertaglia E, Anselmino M, Zorzi A, Russo V, Toso E, Peruzza F, Rapacciuolo A, Migliore F, Gaita F, Cucchini U, De Divitiis M, Iliceto S, Stabile G.
    Journal: Int J Cardiol; 2017 Dec 15; 249():179-183. PubMed ID: 29121724.
    Abstract:
    AIMS: Despite optimal oral anticoagulation with vitamin K antagonist, left atrial (LA) thrombus could be detected in the left appendage (LAA) in >2% of patients with atrial fibrillation (AF) and CHA2DS2-VASc score≥1 but few data are available for patients treated with non-vitamin K antagonist oral anticoagulants (NOACs). We evaluated the occurrence and predictors of LA thrombi by means of transesophageal echocardiography (TOE) in consecutive patients with non-valvular AF who received for at least 3weeks Apixaban, Dabigatran, or Rivaroxaban. METHODS: This study included 414 consecutive patients (male 252, 60.6%, mean age 67.3years) referred to our Centers for catheter ablation of AF (n=220, 53.1%) or scheduled electrical cardioversion (n=194, 46.9%). Patients were on Dabigatran (n=160), Rivaroxaban (n=150) or Apixaban (n=104). TOE was performed in all cases within 12h prior to ablation or cardioversion. RESULTS: Preprocedural TOE revealed LA thrombus in 15/414 patients (3.6%), all located in the LAA (Apixaban 3/104 2.9%, Dabigatran 5/160 3.1%, and Rivaroxaban 7/150 4.7%, p=0.69). Of these, 14 patients had persistent AF. Patients with LAA thrombus had a mean CHA2DS2-VASc score of 3 (3-4). Higher CHA2DS2-VASc score (p=0.02), but not the type of NOAC, significantly predicted the presence of LA thrombus. CONCLUSION: The incidence of LAA thrombus in a cohort of patients anticoagulated with NOACs is low but not negligible, in any case similar among the 3 drugs. Preprocedural TOE should be considered in patients with a CHA2DS2-VASc score>3.
    [Abstract] [Full Text] [Related] [New Search]