Clinical Research
Clinical characteristics and prognosis of the patients with nonvalvular atrial fibrillation combining left atrial thrombosis and the efficacy of the anticoagulant drugs
Lirong Yan, Keping Chen, Jian Ma, Yan Yao, Pihua Fang, Guodong Niu, Yuhe Jia, Jianmin Chu, Shu Zhang
Published 2018-12-28
Cite as Chin J Cardiac Arrhyth, 2018, 22(6): 461-465. DOI: 10.3760/cma.j.issn.1007-6638.2018.06.001
Abstract
ObjectiveTo analysis clinical characteristics and prognosis of the patients with nonvalvular atrial fibrillation(NVAF)combining left atrial thrombosis(LAT)and compare the clinical efficacy of new anticoagulant drugs(NOACs)and warfarin.
MethodsThis study included 101 consecutive NVAF patients referred to our center for catheter ablation and confirmed diagnosis of LAT by transoesophageal echocardiography(TEE)or multidetector computed tomography from January 2016 to December 2017.All patients were anticoagulated with NOACs or warfarin for at least 3 weeks and then performed TEE to evaluate the LAT.This was a single center retrospective study.
ResultsA total of 101 patients were included in this study and 75(74.3%)patients had persistent AF.During follow-up, 95(94.1%)patients were regular anticoagulant drugs and analyzed.LAT was disappeared in 73(76.8%)patients and not in 22(23.2%)patients.Compared with the LAT disappeared group, the LAT not disappeared group had significantly more patients with persistent AF(90.9% vs.69.9%, P<0.05), cardiomyopathy(27.3% vs.5.5%, P<0.05)and CHA2DS2-VASc score≥3 for male or ≥4 for female(50.0% vs.20.5%, P<0.05), respectively.The LAT disappeared group had significantly more patients treated with NOACs than the LAT not disappeared group(75.0% vs.45.5%, P<0.05). LAT was disappeared significantly more in patients on NOAC than that in patients on warfarin(84.8% vs.61.3%, P<0.05). Two independent predictors for disappear of LAT were identified: treated with NOACs and LVEF≥50%.
ConclusionThe LAT were more likely to disappear in NVAF patients treated with NOACs.When NVAF patients who referred for catheter ablation combined with LAT, a NOACs is recommended in preference to warfarin.
Key words:
Anticoagulants; Left atrial thrombosis; Warfarin
Contributor Information
Lirong Yan
Center of Arrhythmia, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
Keping Chen
Jian Ma
Yan Yao
Pihua Fang
Guodong Niu
Yuhe Jia
Jianmin Chu
Shu Zhang