Cargando…
Resolution of left atrial appendage thrombi: No difference between phenprocoumon and non‐vitamin K‐dependent oral antagonists
BACKGROUND: Atrial fibrillation is the most important risk factor for left atrial appendage (LAA) thrombi, a potentially life‐threatening condition. Thrombus resolution may prevent embolic events and allow rhythm‐control strategies, which have been shown to reduce cardiovascular complications. HYPOT...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9175243/ https://www.ncbi.nlm.nih.gov/pubmed/35373849 http://dx.doi.org/10.1002/clc.23823 |
_version_ | 1784722416290758656 |
---|---|
author | Biller, Katharina Biller, Benedikt Findeisen, Hannes Eckardt, Lars Wedekind, Horst |
author_facet | Biller, Katharina Biller, Benedikt Findeisen, Hannes Eckardt, Lars Wedekind, Horst |
author_sort | Biller, Katharina |
collection | PubMed |
description | BACKGROUND: Atrial fibrillation is the most important risk factor for left atrial appendage (LAA) thrombi, a potentially life‐threatening condition. Thrombus resolution may prevent embolic events and allow rhythm‐control strategies, which have been shown to reduce cardiovascular complications. HYPOTHESIS: There is no significant difference between phenprocoumon and non‐Vitamin K‐dependent oral anticoagulants (NOACs) in the resolution of LAA‐thrombi in a real‐world setting. METHODS: Consecutive patients with LAA‐thrombi from June 2013 to June 2017 were included in an observational single‐center analysis. The primary endpoint was defined as the resolution of the thrombus. The observational period was 1 year. Resolutions rates in patients on phenprocoumon or NOACs were compared and the time to resolution was analyzed. RESULTS: We identified 114 patients with LAA‐thrombi. There was no significant difference in the efficacy of resolution between phenprocoumon and NOACs (p = .499) at the time of first control which took place after a mean of 58 ± 42.2 (median 48) days. At first control most thrombi were dissolved (74.6%). The analysis after set‐time intervals revealed a resolution rate of 2/3 of LAA‐thrombi after 8–10 weeks in the phenprocoumon and NOAC groups. After 12 weeks a higher number of thrombi had resolved in the presence of NOAC (89.3%) whereas in the presence of phenprocoumon 68.3% had resolved (p = .046). CONCLUSION: In this large observational study NOACs were found to be potent drugs for the resolution of LAA‐thrombi. In addition, the resolution of LAA‐thrombi was found to be faster in the presence of NOAC as compared to phenprocoumon. |
format | Online Article Text |
id | pubmed-9175243 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91752432022-06-13 Resolution of left atrial appendage thrombi: No difference between phenprocoumon and non‐vitamin K‐dependent oral antagonists Biller, Katharina Biller, Benedikt Findeisen, Hannes Eckardt, Lars Wedekind, Horst Clin Cardiol Clinical Investigations BACKGROUND: Atrial fibrillation is the most important risk factor for left atrial appendage (LAA) thrombi, a potentially life‐threatening condition. Thrombus resolution may prevent embolic events and allow rhythm‐control strategies, which have been shown to reduce cardiovascular complications. HYPOTHESIS: There is no significant difference between phenprocoumon and non‐Vitamin K‐dependent oral anticoagulants (NOACs) in the resolution of LAA‐thrombi in a real‐world setting. METHODS: Consecutive patients with LAA‐thrombi from June 2013 to June 2017 were included in an observational single‐center analysis. The primary endpoint was defined as the resolution of the thrombus. The observational period was 1 year. Resolutions rates in patients on phenprocoumon or NOACs were compared and the time to resolution was analyzed. RESULTS: We identified 114 patients with LAA‐thrombi. There was no significant difference in the efficacy of resolution between phenprocoumon and NOACs (p = .499) at the time of first control which took place after a mean of 58 ± 42.2 (median 48) days. At first control most thrombi were dissolved (74.6%). The analysis after set‐time intervals revealed a resolution rate of 2/3 of LAA‐thrombi after 8–10 weeks in the phenprocoumon and NOAC groups. After 12 weeks a higher number of thrombi had resolved in the presence of NOAC (89.3%) whereas in the presence of phenprocoumon 68.3% had resolved (p = .046). CONCLUSION: In this large observational study NOACs were found to be potent drugs for the resolution of LAA‐thrombi. In addition, the resolution of LAA‐thrombi was found to be faster in the presence of NOAC as compared to phenprocoumon. John Wiley and Sons Inc. 2022-04-04 /pmc/articles/PMC9175243/ /pubmed/35373849 http://dx.doi.org/10.1002/clc.23823 Text en © 2022 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Investigations Biller, Katharina Biller, Benedikt Findeisen, Hannes Eckardt, Lars Wedekind, Horst Resolution of left atrial appendage thrombi: No difference between phenprocoumon and non‐vitamin K‐dependent oral antagonists |
title | Resolution of left atrial appendage thrombi: No difference between phenprocoumon and non‐vitamin K‐dependent oral antagonists |
title_full | Resolution of left atrial appendage thrombi: No difference between phenprocoumon and non‐vitamin K‐dependent oral antagonists |
title_fullStr | Resolution of left atrial appendage thrombi: No difference between phenprocoumon and non‐vitamin K‐dependent oral antagonists |
title_full_unstemmed | Resolution of left atrial appendage thrombi: No difference between phenprocoumon and non‐vitamin K‐dependent oral antagonists |
title_short | Resolution of left atrial appendage thrombi: No difference between phenprocoumon and non‐vitamin K‐dependent oral antagonists |
title_sort | resolution of left atrial appendage thrombi: no difference between phenprocoumon and non‐vitamin k‐dependent oral antagonists |
topic | Clinical Investigations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9175243/ https://www.ncbi.nlm.nih.gov/pubmed/35373849 http://dx.doi.org/10.1002/clc.23823 |
work_keys_str_mv | AT billerkatharina resolutionofleftatrialappendagethrombinodifferencebetweenphenprocoumonandnonvitaminkdependentoralantagonists AT billerbenedikt resolutionofleftatrialappendagethrombinodifferencebetweenphenprocoumonandnonvitaminkdependentoralantagonists AT findeisenhannes resolutionofleftatrialappendagethrombinodifferencebetweenphenprocoumonandnonvitaminkdependentoralantagonists AT eckardtlars resolutionofleftatrialappendagethrombinodifferencebetweenphenprocoumonandnonvitaminkdependentoralantagonists AT wedekindhorst resolutionofleftatrialappendagethrombinodifferencebetweenphenprocoumonandnonvitaminkdependentoralantagonists |