PMID- 29761512
OWN - NLM
STAT- Publisher
LR  - 20180605
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
DP  - 2018 May 14
TI  - Oral anticoagulation and left atrial thrombi resolution in nonrheumatic atrial
      fibrillation or flutter: A systematic review and meta-analysis.
LID - 10.1111/pace.13368 [doi]
AB  - BACKGROUND: Oral anticoagulation (OAC) is prescribed for left atrial thrombi
      (LAT) in nonrheumatic atrial fibrillation (AF) and/or atrial flutter (AFL). The
      study objective was to review the existing evidence regarding LAT resolution in
      nonrheumatic AF and/or AFL with OAC agents. METHODS: Data sources included
      PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL)
      between January 1, 1991 and February 10, 2017. English-language studies that
      assessed LAT resolution with OAC agents in subjects with nonrheumatic AF and/or
      AFL, by serial transesophageal echocardiography, and with follow-up times >/= 3
      weeks and < 1 year, were selected. Study quality was assessed using
      recommendations adapted from the Agency for Healthcare Research and Quality.
      Pooled LAT resolution rates were evaluated for vitamin K antagonist (VKA) studies
      and low risk of bias warfarin studies. RESULTS: The pooled LAT resolution rate of
      619 subjects from 16 VKA studies was 63.7% (95% confidence interval [CI],
      53.3%-72.9%). The pooled LAT resolution rate of 94 subjects from four studies
      that specified warfarin use, exclusion of prior long-term therapeutic OAC, and
      target international normalized ratio (INR) >/= 2.0 and/or average achieved INR
      >/= 2.0 was 79.3% (95% CI, 69.8%-86.4%). Two studies in direct-acting oral
      anticoagulants (DOACs) reported LAT resolution rates of 89.5% (17 of 19) for
      dabigatran and 41.5% (22 of 53) for rivaroxaban. CONCLUSIONS: Warfarin is the
      most studied initial OAC agent for treating LAT in nonrheumatic AF and/or AFL
      with a resolution rate of nearly 80%. Further studies in DOACs are warranted.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Wang, Norman C
AU  - Wang NC
AUID- ORCID: http://orcid.org/0000-0002-8388-2146
AD  - Heart and Vascular Institute, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
FAU - Sather, Matthew D
AU  - Sather MD
AD  - Heart and Vascular Institute, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
FAU - Hussain, Aliza
AU  - Hussain A
AD  - Heart and Vascular Institute, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
FAU - Althouse, Andrew D
AU  - Althouse AD
AD  - Heart and Vascular Institute, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
FAU - Adelstein, Evan C
AU  - Adelstein EC
AD  - Heart and Vascular Institute, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
FAU - Jain, Sandeep K
AU  - Jain SK
AD  - Heart and Vascular Institute, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
FAU - Katz, William E
AU  - Katz WE
AD  - Heart and Vascular Institute, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
FAU - Shalaby, Alaa A
AU  - Shalaby AA
AD  - Heart and Vascular Institute, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
FAU - Voigt, Andrew H
AU  - Voigt AH
AD  - Heart and Vascular Institute, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
FAU - Saba, Samir
AU  - Saba S
AD  - Heart and Vascular Institute, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
LA  - eng
PT  - Journal Article
DEP - 20180514
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
CIN - Pacing Clin Electrophysiol. 2019 Jan;42(1):1-3. PMID: 30488453
OTO - NOTNLM
OT  - atrial fibrillation
OT  - atrial flutter
OT  - left atrial thrombi
OT  - oral anticoagulation
EDAT- 2018/05/16 06:00
MHDA- 2018/05/16 06:00
CRDT- 2018/05/16 06:00
PHST- 2018/03/27 00:00 [received]
PHST- 2018/05/20 00:00 [revised]
PHST- 2018/04/26 00:00 [accepted]
PHST- 2018/05/16 06:00 [pubmed]
PHST- 2018/05/16 06:00 [medline]
PHST- 2018/05/16 06:00 [entrez]
AID - 10.1111/pace.13368 [doi]
PST - aheadofprint
SO  - Pacing Clin Electrophysiol. 2018 May 14. doi: 10.1111/pace.13368.