Cargando…

Left Atrial Thrombus in Atrial Fibrillation/Flutter Patients in Relation to Anticoagulation Strategy: LATTEE Registry

Background: Atrial fibrillation (AF) and flutter (AFl) increase the risk of thromboembolism. The aim of the study was to assess the prevalence of left atrial thrombus (LAT) in AF/AFl in relation to oral anticoagulation (OAC). Methods: LATTEE (NCT03591627) was a multicenter, prospective, observationa...

Descripción completa

Detalles Bibliográficos
Autores principales: Kapłon-Cieślicka, Agnieszka, Gawałko, Monika, Budnik, Monika, Uziębło-Życzkowska, Beata, Krzesiński, Paweł, Starzyk, Katarzyna, Gorczyca-Głowacka, Iwona, Daniłowicz-Szymanowicz, Ludmiła, Kaufmann, Damian, Wójcik, Maciej, Błaszczyk, Robert, Hiczkiewicz, Jarosław, Łojewska, Katarzyna, Mizia-Stec, Katarzyna, Wybraniec, Maciej T, Kosmalska, Katarzyna, Fijałkowski, Marcin, Szymańska, Anna, Dłużniewski, Mirosław, Haberka, Maciej, Kucio, Michał, Michalski, Błażej, Kupczyńska, Karolina, Tomaszuk-Kazberuk, Anna, Wilk-Śledziewska, Katarzyna, Wachnicka-Truty, Renata, Koziński, Marek, Burchardt, Paweł, Scisło, Piotr, Piątkowski, Radosław, Kochanowski, Janusz, Opolski, Grzegorz, Grabowski, Marcin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143266/
https://www.ncbi.nlm.nih.gov/pubmed/35628832
http://dx.doi.org/10.3390/jcm11102705
_version_ 1784715763371737088
author Kapłon-Cieślicka, Agnieszka
Gawałko, Monika
Budnik, Monika
Uziębło-Życzkowska, Beata
Krzesiński, Paweł
Starzyk, Katarzyna
Gorczyca-Głowacka, Iwona
Daniłowicz-Szymanowicz, Ludmiła
Kaufmann, Damian
Wójcik, Maciej
Błaszczyk, Robert
Hiczkiewicz, Jarosław
Łojewska, Katarzyna
Mizia-Stec, Katarzyna
Wybraniec, Maciej T
Kosmalska, Katarzyna
Fijałkowski, Marcin
Szymańska, Anna
Dłużniewski, Mirosław
Haberka, Maciej
Kucio, Michał
Michalski, Błażej
Kupczyńska, Karolina
Tomaszuk-Kazberuk, Anna
Wilk-Śledziewska, Katarzyna
Wachnicka-Truty, Renata
Koziński, Marek
Burchardt, Paweł
Scisło, Piotr
Piątkowski, Radosław
Kochanowski, Janusz
Opolski, Grzegorz
Grabowski, Marcin
author_facet Kapłon-Cieślicka, Agnieszka
Gawałko, Monika
Budnik, Monika
Uziębło-Życzkowska, Beata
Krzesiński, Paweł
Starzyk, Katarzyna
Gorczyca-Głowacka, Iwona
Daniłowicz-Szymanowicz, Ludmiła
Kaufmann, Damian
Wójcik, Maciej
Błaszczyk, Robert
Hiczkiewicz, Jarosław
Łojewska, Katarzyna
Mizia-Stec, Katarzyna
Wybraniec, Maciej T
Kosmalska, Katarzyna
Fijałkowski, Marcin
Szymańska, Anna
Dłużniewski, Mirosław
Haberka, Maciej
Kucio, Michał
Michalski, Błażej
Kupczyńska, Karolina
Tomaszuk-Kazberuk, Anna
Wilk-Śledziewska, Katarzyna
Wachnicka-Truty, Renata
Koziński, Marek
Burchardt, Paweł
Scisło, Piotr
Piątkowski, Radosław
Kochanowski, Janusz
Opolski, Grzegorz
Grabowski, Marcin
author_sort Kapłon-Cieślicka, Agnieszka
collection PubMed
description Background: Atrial fibrillation (AF) and flutter (AFl) increase the risk of thromboembolism. The aim of the study was to assess the prevalence of left atrial thrombus (LAT) in AF/AFl in relation to oral anticoagulation (OAC). Methods: LATTEE (NCT03591627) was a multicenter, prospective, observational study enrolling consecutive patients with AF/AFl referred for transesophageal echocardiography before cardioversion or ablation. Results: Of 3109 patients enrolled, 88% were on chronic, 1.5% on transient OAC and 10% without OAC. Of patients on chronic OAC, 39% received rivaroxaban, 30% dabigatran, 14% apixaban and 18% vitamin K antagonists (VKA). Patients on apixaban were oldest, had the worst renal function and were highest in both bleeding and thromboembolic risk, and more often received reduced doses. Prevalence of LAT was 8.0% (7.3% on chronic OAC vs. 15% without OAC; p < 0.01). In patients on VKA, prevalence of LAT was doubled compared to patients on non-VKA-OACs (NOACs) (13% vs. 6.0%; p < 0.01), even after propensity score weighting (13% vs. 7.5%; p < 0.01). Prevalence of LAT in patients on apixaban was higher (9.8%) than in those on rivaroxaban (5.7%) and dabigatran (4.7%; p < 0.01 for both comparisons), however, not after propensity score weighting. Conclusions: The prevalence of LAT in AF is non-negligible even on chronic OAC. The risk of LAT seems higher on VKA compared to NOAC, and similar between different NOACs.
format Online
Article
Text
id pubmed-9143266
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-91432662022-05-29 Left Atrial Thrombus in Atrial Fibrillation/Flutter Patients in Relation to Anticoagulation Strategy: LATTEE Registry Kapłon-Cieślicka, Agnieszka Gawałko, Monika Budnik, Monika Uziębło-Życzkowska, Beata Krzesiński, Paweł Starzyk, Katarzyna Gorczyca-Głowacka, Iwona Daniłowicz-Szymanowicz, Ludmiła Kaufmann, Damian Wójcik, Maciej Błaszczyk, Robert Hiczkiewicz, Jarosław Łojewska, Katarzyna Mizia-Stec, Katarzyna Wybraniec, Maciej T Kosmalska, Katarzyna Fijałkowski, Marcin Szymańska, Anna Dłużniewski, Mirosław Haberka, Maciej Kucio, Michał Michalski, Błażej Kupczyńska, Karolina Tomaszuk-Kazberuk, Anna Wilk-Śledziewska, Katarzyna Wachnicka-Truty, Renata Koziński, Marek Burchardt, Paweł Scisło, Piotr Piątkowski, Radosław Kochanowski, Janusz Opolski, Grzegorz Grabowski, Marcin J Clin Med Article Background: Atrial fibrillation (AF) and flutter (AFl) increase the risk of thromboembolism. The aim of the study was to assess the prevalence of left atrial thrombus (LAT) in AF/AFl in relation to oral anticoagulation (OAC). Methods: LATTEE (NCT03591627) was a multicenter, prospective, observational study enrolling consecutive patients with AF/AFl referred for transesophageal echocardiography before cardioversion or ablation. Results: Of 3109 patients enrolled, 88% were on chronic, 1.5% on transient OAC and 10% without OAC. Of patients on chronic OAC, 39% received rivaroxaban, 30% dabigatran, 14% apixaban and 18% vitamin K antagonists (VKA). Patients on apixaban were oldest, had the worst renal function and were highest in both bleeding and thromboembolic risk, and more often received reduced doses. Prevalence of LAT was 8.0% (7.3% on chronic OAC vs. 15% without OAC; p < 0.01). In patients on VKA, prevalence of LAT was doubled compared to patients on non-VKA-OACs (NOACs) (13% vs. 6.0%; p < 0.01), even after propensity score weighting (13% vs. 7.5%; p < 0.01). Prevalence of LAT in patients on apixaban was higher (9.8%) than in those on rivaroxaban (5.7%) and dabigatran (4.7%; p < 0.01 for both comparisons), however, not after propensity score weighting. Conclusions: The prevalence of LAT in AF is non-negligible even on chronic OAC. The risk of LAT seems higher on VKA compared to NOAC, and similar between different NOACs. MDPI 2022-05-11 /pmc/articles/PMC9143266/ /pubmed/35628832 http://dx.doi.org/10.3390/jcm11102705 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kapłon-Cieślicka, Agnieszka
Gawałko, Monika
Budnik, Monika
Uziębło-Życzkowska, Beata
Krzesiński, Paweł
Starzyk, Katarzyna
Gorczyca-Głowacka, Iwona
Daniłowicz-Szymanowicz, Ludmiła
Kaufmann, Damian
Wójcik, Maciej
Błaszczyk, Robert
Hiczkiewicz, Jarosław
Łojewska, Katarzyna
Mizia-Stec, Katarzyna
Wybraniec, Maciej T
Kosmalska, Katarzyna
Fijałkowski, Marcin
Szymańska, Anna
Dłużniewski, Mirosław
Haberka, Maciej
Kucio, Michał
Michalski, Błażej
Kupczyńska, Karolina
Tomaszuk-Kazberuk, Anna
Wilk-Śledziewska, Katarzyna
Wachnicka-Truty, Renata
Koziński, Marek
Burchardt, Paweł
Scisło, Piotr
Piątkowski, Radosław
Kochanowski, Janusz
Opolski, Grzegorz
Grabowski, Marcin
Left Atrial Thrombus in Atrial Fibrillation/Flutter Patients in Relation to Anticoagulation Strategy: LATTEE Registry
title Left Atrial Thrombus in Atrial Fibrillation/Flutter Patients in Relation to Anticoagulation Strategy: LATTEE Registry
title_full Left Atrial Thrombus in Atrial Fibrillation/Flutter Patients in Relation to Anticoagulation Strategy: LATTEE Registry
title_fullStr Left Atrial Thrombus in Atrial Fibrillation/Flutter Patients in Relation to Anticoagulation Strategy: LATTEE Registry
title_full_unstemmed Left Atrial Thrombus in Atrial Fibrillation/Flutter Patients in Relation to Anticoagulation Strategy: LATTEE Registry
title_short Left Atrial Thrombus in Atrial Fibrillation/Flutter Patients in Relation to Anticoagulation Strategy: LATTEE Registry
title_sort left atrial thrombus in atrial fibrillation/flutter patients in relation to anticoagulation strategy: lattee registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143266/
https://www.ncbi.nlm.nih.gov/pubmed/35628832
http://dx.doi.org/10.3390/jcm11102705
work_keys_str_mv AT kapłoncieslickaagnieszka leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT gawałkomonika leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT budnikmonika leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT uziebłozyczkowskabeata leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT krzesinskipaweł leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT starzykkatarzyna leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT gorczycagłowackaiwona leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT daniłowiczszymanowiczludmiła leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT kaufmanndamian leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT wojcikmaciej leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT błaszczykrobert leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT hiczkiewiczjarosław leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT łojewskakatarzyna leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT miziasteckatarzyna leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT wybraniecmaciejt leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT kosmalskakatarzyna leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT fijałkowskimarcin leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT szymanskaanna leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT dłuzniewskimirosław leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT haberkamaciej leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT kuciomichał leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT michalskibłazej leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT kupczynskakarolina leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT tomaszukkazberukanna leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT wilksledziewskakatarzyna leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT wachnickatrutyrenata leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT kozinskimarek leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT burchardtpaweł leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT scisłopiotr leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT piatkowskiradosław leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT kochanowskijanusz leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT opolskigrzegorz leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry
AT grabowskimarcin leftatrialthrombusinatrialfibrillationflutterpatientsinrelationtoanticoagulationstrategylatteeregistry