Efficacy of Dabigatran on Left Atrial Appendage Thrombus in Patients with Atrial Fibrillation
The direct thrombin inhibitor dabigatran has shown interesting efficacy in a smaller clinical study in patients with atrial fibrillation and a thrombus in the left atrial appendage. Chinese authors evaluated the results of anticoagulant therapy using transthoracic and transesophageal echocardiography.
Methodology and Course of the Study
A total of 58 patients with paroxysmal or persistent atrial fibrillation and a thrombus in the left atrial appendage were examined at study entry and after 3 months of treatment with dabigatran at a dose of 150 mg twice daily. The participants were on average 59.2 ± 7.7 years old, and the majority were men (69%). After treatment, they were divided into groups with achieved treatment effect and without effect, and the baseline ultrasound values were compared between these groups: left atrium diameter, left atrium ejection fraction, left ventricle ejection fraction, left atrial appendage flow velocity, and thrombus size.
Findings
After 3 months of dabigatran treatment, complete thrombus resolution was observed in 15 (25.9%) patients. Significant thrombus reduction occurred in 21 patients. Thus, the proportion of patients with achieved treatment effect was 62.1% (36 out of 58 study participants).
Compared to the group where treatment efficacy was not achieved, patients with achieved efficacy had a smaller average left atrium diameter at study entry and less often had persistent atrial fibrillation. Moreover, they had a higher left atrium ejection fraction and higher left atrial appendage flow velocity at study entry. The differences were statistically significant (p < 0.05).
Multivariate logistic regression analysis showed that factors independently associated with achieving dabigatran efficacy in these patients include the type of atrial fibrillation, left atrium diameter, its ejection fraction, and left atrial appendage flow velocity.
(zza)
Source: Xing X. F., Liu N. N., Han Y. L. et al. Anticoagulation efficacy of dabigatran etexilate for left atrial appendage thrombus in patients with atrial fibrillation by transthoracic and transesophageal echocardiography. Medicine (Baltimore) 2018; 97 (26): e11117, doi: 10.1097/MD.0000000000011117.
Did you like this article? Would you like to comment on it? Write to us. We are interested in your opinion. We will not publish it, but we will gladly answer you.
