Cardiovascular Outcomes in Patients with Atrial Flutter and Oral Anticoagulation: The Predictive Role of Left Atrial Appendage Thrombus in a Long-Term, Prospective, Observational Cohort Study
2024

Cardiovascular Outcomes in Patients with Atrial Flutter and Anticoagulation

Sample size: 90 publication Evidence: moderate

Author Information

Author(s): Łukasz Turek, Marcin Sadowski, Jacek Kurzawski, Mariana Janion

Primary Institution: Jan Kochanowski University, Kielce, Poland

Hypothesis

Does left atrial appendage thrombus (LAAT) in individuals with atrial flutter (AFL) receiving anticoagulation enhance the risk of cardiovascular morbidity and mortality?

Conclusion

The presence of LAAT does not significantly impact cardiovascular outcomes in patients with AFL on anticoagulation.

Supporting Evidence

  • LAAT was identified in 10% of patients.
  • No significant differences in cardiovascular outcomes were found between patients with and without LAAT.
  • Higher CHA2DS2-VASc scores and previous myocardial infarction were associated with higher hospitalization rates due to heart failure.
  • Lower left ventricular ejection fraction was linked to higher rates of cardiovascular death.

Takeaway

This study looked at patients with a heart condition called atrial flutter and found that having a specific type of blood clot in the heart didn't make them more likely to have serious heart problems if they were taking blood thinners.

Methodology

This was a prospective observational cohort study involving 90 patients with atrial flutter on anticoagulation, followed for a median of 2114.5 days to assess cardiovascular outcomes.

Potential Biases

Potential overdiagnosis of blood clots due to lack of ultrasound contrast media.

Limitations

The study had a small sample size and did not include patients on edoxaban; compliance with anticoagulant treatment was not verified.

Participant Demographics

Patients were adults (age ≥ 18 years) on chronic oral anticoagulants, with a median age of approximately 70 years.

Statistical Information

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3390/jcm13247724

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