title: 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.
authors.affiliation: Department of Cardiology, Ohara Medical Center, Fukushima, Japan.
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Abe
authors.forename: Tukasa
authors.initials: T
authors.lastname: Asakura
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Shunichi
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Syuichi
authors.initials: S
authors.lastname: Muroi
authors.forename: Fujiko
authors.initials: F
authors.lastname: Saitoh
authors.forename: Masahiko
authors.initials: M
authors.lastname: Satoh
authors.forename: Shigebumi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ono
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sakabe
authors.forename: Masumi
authors.initials: M
authors.lastname: Iwai
authors.forename: Masahito
authors.initials: M
authors.lastname: Sando
authors.forename: Jun
authors.initials: J
authors.lastname: Gotou
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Kenji
authors.initials: K
authors.lastname: Nagata
authors.forename: Kazuhira
authors.initials: K
authors.lastname: Maehara
authors.forename: Yukio
authors.initials: Y
authors.lastname: Maruyama
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications*; D018572:Disease-Free Survival; D004359:Drug Therapy, Combination; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D016019:Survival Analysis; D013927:Thrombosis / Q000145:classification / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D013988:Ticlopidine / Q000627:therapeutic use; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D014859:Warfarin; D013988:Ticlopidine; D001241:Aspirin