Comparison of Long-Term Outcomes Between Combination Antiplatelet and Anticoagulant Therapy and Anticoagulant Monotherapy in Patients With Atrial Fibrillation and Left Atrial Thrombi

• Published in: Circulation Reports 2020/09/10, Vol.2(9), pp.457-465
• Main Authors: Sunaga, Akihiro, Hikoso, Shungo, Nakatani, Daisaku, Inoue, Koichi, Okuyama, Yuji, Egami, Yasuyuki, Kashiwase, Kazunori, Hirata, Akio, Masuda, Masaharu, Furukawa, Yoshio, Watanabe, Tetsuya, Mizuno, Hiroya, Okada, Katsuki, Dohi, Tomoharu, Kitamura, Tetsuhisa, Komukai, Sho, Kurakami, Hiroyuki, Yamada, Tomomi, Takeda, Toshihiro, Kida, Hirota, Oeun, Bolrathanak, Kojima, Takayuki, Minamiguchi, Hitoshi, Sakata, Yasushi, Investigators, for the OCVC
• Format: Article
• Language: English
• Subjects: Arrhythmia/Electrophysiology; Atrial fibrillation; Bleeding; Inverse probability of treatment weighting; Left atrial thrombi; Net clinical benefit; Original article
• ISSN: 2434-0790; 2434-0790
• DOI: 10.1253/circrep.CR-20-0036

Background:Anticoagulation for patients with atrial fibrillation (AF) complicated by left atrial thrombi (LAT) is a frequent cause of bleeding complications, but risk factors remain unknown.Methods and Results:Of 3,139 AF patients who underwent transesophageal echocardiography, 82 with LAT under anticoagulation were included in this study. Patients treated with combination antiplatelet and anticoagulant therapy (n=31) were compared with those receiving anticoagulant monotherapy (n=51) to investigate the effects of antiplatelet agents during anticoagulation on bleeding complications. Over a mean (±SD) follow-up of 878±486 days, bleeding events occurred more frequently in the combination therapy than monotherapy group (58% vs. 20%; P