Heart Failure and the Non-Resolution of Atrial Thrombus Detected in Anticoagulated Patients with Non-Valvular Atrial Fibrillation

Background To investigate the relationship between heart failure (HF) and the non-resolution of atrial thrombus detected in anticoagulated patients with non-valvular atrial fibrillation (NVAF). Methods This was a single-center, observational, retrospective, and prospective study. Anticoagulated pati...

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Main Authors: Shu Yang MD, Jie Yang MM, Ning Chen MD, Chang Cui MD, Jincheng Jiao MD, Li Zhu MD, Mingfang Li MD, Minglong Chen MD
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Clinical and Applied Thrombosis/Hemostasis
Online Access:https://doi.org/10.1177/10760296251324922
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author Shu Yang MD
Jie Yang MM
Ning Chen MD
Chang Cui MD
Jincheng Jiao MD
Li Zhu MD
Mingfang Li MD
Minglong Chen MD
author_facet Shu Yang MD
Jie Yang MM
Ning Chen MD
Chang Cui MD
Jincheng Jiao MD
Li Zhu MD
Mingfang Li MD
Minglong Chen MD
author_sort Shu Yang MD
collection DOAJ
description Background To investigate the relationship between heart failure (HF) and the non-resolution of atrial thrombus detected in anticoagulated patients with non-valvular atrial fibrillation (NVAF). Methods This was a single-center, observational, retrospective, and prospective study. Anticoagulated patients with NVAF and atrial thrombus identified by transesophageal echocardiography or cardiac computed tomography angiography were consecutively enrolled. All patients received follow-up imaging within 6 months to assess the resolution of atrial thrombus. The primary endpoint was the resolution of atrial thrombus and the secondary endpoint was the occurrence of ischemic stroke, major bleeding, and all-cause death during the follow-up period. Results Among 8987 patients with NVAF scheduled for catheter ablation or cardioversion, 70 anticoagulated patients with atrial thrombus were final analyzed. The average age was 61.8±10.6 years, 62.9% of them were men, and 32 (45.7%) patients presented with HF. Within the 6-month follow-up period, atrial thrombus resolution was observed in 47 (67.1%) patients. The rate of atrial thrombus resolution was lower in patients with baseline HF (50.0% vs 81.6%). In the adjusted logistic regression analysis model, HF was independently associated with the non-resolution of atrial thrombus (adjusted OR: 5.38, 95% CI: 1.19-24.27). During the median follow-up period of 4.5 years, four ischemic stroke events occurred in four patients. None of the patients in this study experienced major bleeding events or death during follow-up. Conclusions HF was associated with the non-resolution of atrial thrombus detected in anticoagulated patients with NVAF. Further research is needed to identify optimal therapeutic approaches for this high-risk population.
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spelling doaj-art-1e0dfac37b3e446dbb28cbb23107298d2025-08-20T02:56:39ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232025-03-013110.1177/10760296251324922Heart Failure and the Non-Resolution of Atrial Thrombus Detected in Anticoagulated Patients with Non-Valvular Atrial FibrillationShu Yang MD0Jie Yang MM1Ning Chen MD2Chang Cui MD3Jincheng Jiao MD4Li Zhu MD5Mingfang Li MD6Minglong Chen MD7 Division of Cardiology, , Jiangsu, China Division of Cardiology, , Jiangsu, China Division of Cardiology, , Jiangsu, China Division of Cardiology, , Jiangsu, China , Nanjing, Jiangsu, China Division of Cardiology, , Taizhou, Jiangsu, China , Suqian, Jiangsu, China Division of Cardiology, , Jiangsu, ChinaBackground To investigate the relationship between heart failure (HF) and the non-resolution of atrial thrombus detected in anticoagulated patients with non-valvular atrial fibrillation (NVAF). Methods This was a single-center, observational, retrospective, and prospective study. Anticoagulated patients with NVAF and atrial thrombus identified by transesophageal echocardiography or cardiac computed tomography angiography were consecutively enrolled. All patients received follow-up imaging within 6 months to assess the resolution of atrial thrombus. The primary endpoint was the resolution of atrial thrombus and the secondary endpoint was the occurrence of ischemic stroke, major bleeding, and all-cause death during the follow-up period. Results Among 8987 patients with NVAF scheduled for catheter ablation or cardioversion, 70 anticoagulated patients with atrial thrombus were final analyzed. The average age was 61.8±10.6 years, 62.9% of them were men, and 32 (45.7%) patients presented with HF. Within the 6-month follow-up period, atrial thrombus resolution was observed in 47 (67.1%) patients. The rate of atrial thrombus resolution was lower in patients with baseline HF (50.0% vs 81.6%). In the adjusted logistic regression analysis model, HF was independently associated with the non-resolution of atrial thrombus (adjusted OR: 5.38, 95% CI: 1.19-24.27). During the median follow-up period of 4.5 years, four ischemic stroke events occurred in four patients. None of the patients in this study experienced major bleeding events or death during follow-up. Conclusions HF was associated with the non-resolution of atrial thrombus detected in anticoagulated patients with NVAF. Further research is needed to identify optimal therapeutic approaches for this high-risk population.https://doi.org/10.1177/10760296251324922
spellingShingle Shu Yang MD
Jie Yang MM
Ning Chen MD
Chang Cui MD
Jincheng Jiao MD
Li Zhu MD
Mingfang Li MD
Minglong Chen MD
Heart Failure and the Non-Resolution of Atrial Thrombus Detected in Anticoagulated Patients with Non-Valvular Atrial Fibrillation
Clinical and Applied Thrombosis/Hemostasis
title Heart Failure and the Non-Resolution of Atrial Thrombus Detected in Anticoagulated Patients with Non-Valvular Atrial Fibrillation
title_full Heart Failure and the Non-Resolution of Atrial Thrombus Detected in Anticoagulated Patients with Non-Valvular Atrial Fibrillation
title_fullStr Heart Failure and the Non-Resolution of Atrial Thrombus Detected in Anticoagulated Patients with Non-Valvular Atrial Fibrillation
title_full_unstemmed Heart Failure and the Non-Resolution of Atrial Thrombus Detected in Anticoagulated Patients with Non-Valvular Atrial Fibrillation
title_short Heart Failure and the Non-Resolution of Atrial Thrombus Detected in Anticoagulated Patients with Non-Valvular Atrial Fibrillation
title_sort heart failure and the non resolution of atrial thrombus detected in anticoagulated patients with non valvular atrial fibrillation
url https://doi.org/10.1177/10760296251324922
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