Embolic attack in patients with atrial fibrillation and atrial thrombus depends on the character of the thrombus.
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.
Abe
Yukihiko
Y
Department of Cardiology, Ohara Medical Center, Fukushima, Japan.
Asakura
Tukasa
T
Sakamoto
Nobuo
N
Ishikawa
Shunichi
S
Muroi
Syuichi
S
Saitoh
Fujiko
F
Satoh
Masahiko
M
Suzuki
Shigebumi
S
Ono
Masahiro
M
Sakabe
Atsushi
A
Iwai
Masumi
M
Sando
Masahito
M
Gotou
Jun
J
Watanabe
Yasuyuki
Y
Nagata
Kenji
K
Maehara
Kazuhira
K
Maruyama
Yukio
Y
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
D014859:Warfarin; D013988:Ticlopidine; D001241:Aspirin