scholarly journals The Use of Novel Non-Vitamin K Antagonist Oral Anticoagulants Following Closure of the Left Atrial Appendage: Preliminary Results of Clinical Follow-Up

2021 ◽  
Vol Volume 15 ◽  
pp. 1067-1073
Author(s):  
Jing Zhu ◽  
Jian Xu
Keyword(s):  
Vitamin K ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Atrial Appendage ◽  
Preliminary Results

scholarly journals Outcomes of left atrial appendage occlusion vs. non-vitamin K antagonist oral anticoagulants in atrial fibrillation

2022 ◽  
Author(s):  
Wern Yew Ding ◽  
José Miguel Rivera-Caravaca ◽  
Elnara Fazio-Eynullayeva ◽  
Paula Underhill ◽  
Dhiraj Gupta ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Atrial Appendage ◽  
Research Network ◽  
Suitable Alternative ◽  
Left Atrial Appendage Occlusion

Abstract Background The effects of left atrial appendage (LAA) occlusion compared to non-vitamin K antagonist oral anticoagulant (NOAC) therapy in patients with atrial fibrillation (AF) remain unknown. Aims We aimed to evaluate the outcomes in patients with AF who received LAA occlusion vs. NOAC therapy. Methods We utilised data from TriNetX which is a global federated health research network currently containing data for 88.5 million patients. ICD-10 codes were employed to identify AF patients treated with either LAA occlusion or NOAC between 1st December 2010 and 17th January 2019. Clinical outcomes of interest were analysed up to 2 years. Results 108,697 patients were included. Patients who underwent LAA occlusion were younger, more likely to be white Caucasian and male, had a greater incidence of comorbidities, and were less likely to be prescribed other cardiovascular medications. Using propensity score matching, the risk of all-cause mortality was significantly lower among patients who received LAA occlusion compared to NOAC therapy [1.51% vs. 5.60%, RR 0.27 (95% CI 0.14–0.54)], but there were no statistical differences in the composite thrombotic or thromboembolic events [8.17% vs. 7.72%, RR 1.06 (95% CI 0.73–1.53)], ischaemic stroke or TIA [4.69% vs. 5.45%, RR 0.86 (95% CI 0.54–1.38)], venous thromboembolism [1.66% vs. 1.51%, RR 1.10 (95% CI 0.47–2.57)] and intracranial haemorrhage [1.51% vs. 1.51%, RR 1.00 (95% CI 0.42–2.39)]. Conclusion Overall, LAA occlusion might be a suitable alternative to NOAC therapy for stroke prevention in patients with AF. Graphical abstract

scholarly journals Successful Resolution of a Large Left Atrial and Left Atrial Appendage Thrombus with Rivaroxaban

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Safwan Gaznabi ◽  
Ashraf Abugroun ◽  
Hasan Mahbub ◽  
Enrique Campos
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Atrial Appendage ◽  
Limited Data ◽  
Successful Resolution ◽  
History Of ◽  
Improve Treatment Efficacy

A 79-year-old male was admitted to the hospital for acute exacerbation of heart failure. The patient had history of atrial fibrillation and was planned for cardioversion. Preprocedure transesophageal echocardiogram (TEE) revealed a large multilobulated mobile thrombus in the left atrial appendage. The patient refused warfarin therapy and instead chose to take rivaroxaban. Upon outpatient follow-up, 3 months later, no visible thrombus was appreciated on repeat TEE. This case demonstrates successful resolution of left atrial and left atrial appendage thrombi with the use of rivaroxaban. At present time, limited data is available to support the use of rivaroxaban for treatment of intracardiac thrombi. This case highlights the need for further studies to investigate the outcomes and relative efficiency of use of direct oral anticoagulants (DOACs) in lysis of intracardiac thrombus. The benefits of DOACs compared to the standard of therapy could increase patient compliance, reduce length of stay, and improve treatment efficacy.

Sign in / Sign up

Export Citation Format

Share Document