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Embolic attack in patients with atrial fibrillation and atrial thrombus depends on the character of the thrombus.

Abstract
It is very important to prevent embolisms from left atrial thrombi (LAT). The present study was a trial for the management of patients with AT using 122 patients with atrial fibrillation and LAT who were followed for 1 year after transesophageal echocardiography. LAT were classified by their shape and mobility into the mobile ball type (MB, n=28), fixed ball type (FB, n=32) and mountain type (MO, n=42). The patients were given warfarin (INR: 1.5-2.0, n=43), aspirin 81 mg (n=74) and/or ticlopidine 200 mg/day (n=31). The embolic rate (ER) in the MB group was significantly higher than in the other groups [ie, MB 39.3% vs FB 15.6% (p<0.05), vs MO 2.4% (p<0.05)]. The ER in the FB group was significantly higher than in the MO group (p<0.05). Therapy with a combination of ticlopidine and aspirin reduced the ER in the patients with ball thrombi. The ER of the ball thrombus type group, especially the MB group, was very high in spite of therapy with anti-coagulants and/or anti-platelet agents, and such patients should be treated by early surgical intervention. However, the combination of ticlopidine and aspirin may be useful for preventing embolism.
AuthorsYukihiko Abe, Tukasa Asakura, Nobuo Sakamoto, Shunichi Ishikawa, Syuichi Muroi, Fujiko Saitoh, Masahiko Satoh, Shigebumi Suzuki, Masahiro Ono, Atsushi Sakabe, Masumi Iwai, Masahito Sando, Jun Gotou, Yasuyuki Watanabe, Kenji Nagata, Kazuhira Maehara, Yukio Maruyama
JournalCirculation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 67 Issue 3 Pg. 203-8 (Mar 2003) ISSN: 1346-9843 [Print] Japan
PMID12604867 (Publication Type: Journal Article)
Chemical References
  • Warfarin
  • Ticlopidine
  • Aspirin
Topics
  • Aged
  • Aspirin (therapeutic use)
  • Atrial Fibrillation (complications)
  • Disease-Free Survival
  • Drug Therapy, Combination
  • Echocardiography, Transesophageal
  • Embolism (etiology, prevention & control)
  • Female
  • Heart Atria (pathology)
  • Humans
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Survival Analysis
  • Thrombosis (classification, complications, drug therapy, pathology)
  • Ticlopidine (therapeutic use)
  • Warfarin (therapeutic use)

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