Presence of Thrombus and spontaneous Contrast in the left atrium of Patients with atrial Fibrillation anticoagulated with dabigatran and acenocoumarol
Year: 2015
Type: article
Abstract: Background: Dabigatran (DAB) has shown similar efficacy to warfarin in the prevention of embolism in patients with atrial fibrillation (AF), but it should be administered with caution in elderly patients.Left atrial thrombus is an important marker of embolism.Objectives: The aim of this study was to evaluate the presence of left atrial thrombus and spontaneous contrast in patients ≥65 years with persistent AF in planned electrical cardioversion, receiving DAB or acenocoumarol (AC) treatment, and to assess the occurrence of thromboembolic and hemorrhagic events at one-month follow-up.Methods: Patients ≥65 years with persistent AF in planned electrical cardioversion and with DAB (110 mg or 150 mg b.i.d. in ≥ or <75 year-old patients, respectively) or AC treatment were prospectively included in the study.Transesophageal echocardiography prior to cardioversion examined for the presence of thrombus and spontaneous contrast in the left atrium.Secondary endpoints were cerebral or systemic thromboembolism and major bleeding at one month follow-up.Results: A total of 101 patients were included in the study; 45 received DAB (23 at a dose of 110 mg and 22 at a dose of 150 mg) and 56 AC.Left atrial thrombus was found in 8.9% versus 19.6% [RR 0.45 (95% CI 0.15-1.32);p=0.08] and spontaneous contrast in 20% versus 44.5% [RR 0.44 (95% CI 0.23-0.86);p=0.007] of cases in DAB and AC groups, respectively.Two embolisms were registered at one month, both in the AC group (p=0.3) and 4 patients with major bleeding, two in each group (p=0.5). Conclusions:Patients treated with DAB presented with less spontaneous left atrial contrast and lower trend of thrombus than patients with AC.No differences were found in the rate of embolisms and major bleeding at one-month follow-up.
Institution: Hospital César Milstein
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4413421387