Left Atrial Appendage Thrombus Formation Despite Continuous Non-Vitamin K Antagonist Oral Anticoagulant Therapy in Atrial Fibrillation Patients Undergoing Electrical Cardioversion or Catheter Ablation: A Comparison of Dabigatran and Rivaroxaban
Table 3
Comparison of patients with and without left atrial appendage thrombus among patients treated with dabigatran and rivaroxaban.
Variable
Patients treated with dabigatran (n = 603)
Patients treated with rivaroxaban (n = 653)
With LAAT (n = 30)
Without LAAT (n = 573)
With LAAT (n = 21)
Without LAAT (n = 632)
Female, n (%)
15 (50.0)
200 (34.9)
0.0924
7 (33.3)
257 (40.7)
0.5006
Age, mean ± SD Median (IQR), years
68.9 ± 8.6
61.8 ± 11.3
0.0008
67.0 ± 8.9
62.5 ± 11.6
0.0590
68.0 (65.0, 74.0)
63.0 (56.0, 69.0)
70.0 (61.0, 73.0)
64.0 (57.0, 70.0)
NOAC reduced dose, n (%)
5 (16.7)
47 (8.2)
0.1685
56 (8.9)
56 (8.9)
0.7091
Clinical characteristics, n (%)
Heart failure
16 (53.3)
115 (20.1)
<0.0001
11 (52.4)
121 (19.1)
0.0009
Hypertension
22 (73.3)
416 (72.6)
0.93
18 (85.7)
455 (72.0)
0.1663
Diabetes mellitus
12 (40.0)
107 (18.7)
0.042
6 (28.6)
106 (16.8)
0.2325
Stroke/TIA/embolism peripheral
3 (10.0)
48 (8.4)
0.7334
2 (9.5)
40 (6.3)
0.6388
Vascular disease
10 (33.3)
118 (20.6)
0.0962
5 (23.8)
121 (19.1)
0.5766
AF type, n (%)
Paroxysmal
2 (6.7)
227 (39.6)
<0.0001
2 (9.5)
286 (45.3)
<0.0001
Persistent
21 (70.0)
315 (55.0)
11 (52.4)
327 (51.7)
Permanent
7 (23.3)
7 (23.3)
19 (3.0)
8 (38.1)
Non-paroxysmal
28 (93.3)
346 (60.4)
0.0003
19 (90.5)
346 (54.7)
0.0012
Thromboembolism risk
CHADS2, mean ± SD median (IQR)
2.1 ± 1.2
1.4 ± 1.1
0.0013
1.9 ± 1.0
1.3 ± 1.1
0.0081
2.0 (1.0, 3.0)
1.0 (1.0, 2.0)
2.0 (1.0, 2.0)
1.0 (1.0, 2.0)
CHADS2 = 0, n (%)
2 (6.7)
117 (20.4)
0.0127
1 (4.8)
127 (20.1)
0.0165
CHADS2 = 1, n (%)
9 (30.0)
242 (42.2)
6 (28.6)
279 (44.1)
CHADS2 ≥ 2, n (%)
19 (63.3)
214 (37.3)
14 (66.7)
226 (35.8)
CHA2DS2-VASc, mean ± SD Median (IQR)
3.7 ± 1.7
2.4 ± 1.7
<0.0001
3.0 ± 1.4
2.4 ± 1.6
0.0309
3.5 (2.0, 5.0)
2.0 (1.0, 3.0)
3.0 (3.0, 4.0)
2.0 (1.0, 3.0)
CHA2DS2-VASc = 0, n (%)
0 (0.0)
72 (12.6)
0.0078
1 (4.8)
62 (9.8)
0.2026
CHA2DS2-VASc = 1, n (%)
2 (6.7)
120 (20.9)
2 (9.5)
156 (24.7)
CHA2DS2-VASc ≥ 2, n (%)
28 (93.3)
381 (66.5)
18 (85.8)
414 (65.5)
CHA2DS2-VASc-RAF, mean ± SD Median (IQR)
9.7 ± 4.1
5.5 ± 3.5
<0.0001
9.5 ± 4.6
5.2 ± 3.5
<0.0001
9.5 (7.0, 11.8)
5.0 (3.0, 8.0)
7.0 (7.0, 13.0)
5.0 (2.0, 7.0)
R2CHADS, mean ± SD Median (IQR),
3.2 ± 1.5
1.9 ± 1.5
<0.0001
2.8 ± 1.5
1.9 ± 1.5
0.0051
3.0 (2.0, 4.0)
2.0 (1.0, 3.0)
3.0 (2.0, 3.0)
1.0 (1.0, 3.0)
Bleeding risk
HASBLED, mean ± SD Median (IQR)
1.9 ± 1.0
1.4 ± 1.0
0.0107
1.9 ± 1.2
1.4 ± 0.9
0.0822
2.0 (1.0, 2.0)
1.0 (1.0, 2.0)
2.0 (1.0, 2.0)
1.0 (1.0, 2.0)
HASBLED < 3
24 (80.0)
496 (86.6)
0.2833
17 (81.0)
567 (89.7)
0.2645
Laboratory tests
eGFR, mean ± SD
62.8 ± 18.9
71.3 ± 16.9
0.0076
69.5 ± 20.6
73.6 ± 18.6
0.5156
Median (IQR)
59.6 (50.6, 76.6)
70.8 (58.3, 87.4)
71.3 (52.0, 90.0)
74.6 (58.9, 90.0)
eGFR < 60 ml/min/1.73 m2
16 (53.3)
159 (27.7)
0.0026
9 (42.9)
175 (27.7)
0.1285
AF, atrial fibrillation; eGFR, estimated glomerular filtration rate; LAAT, left atrial appendage thrombus; NOAC, non-vitamin K antagonist oral anticoagulants; SD, standard deviation; TIA, transient ischaemic attack.
