Echocardiographic Risk Factors for Stroke and Outcomes in Patients With Atrial Fibrillation Anticoagulated With Apixaban or Warfarin

Stroke; a Journal of Cerebral Circulation
Dragos VinereanuARISTOTLE Investigators

Abstract

Few data exist on the long-term outcomes of patients with spontaneous echo contrast (SEC), left atrial/left atrial appendage (LA/LAA) thrombus, and complex aortic plaque (CAP), in patients with atrial fibrillation receiving oral anticoagulation. We explored the relationship between these 3 echocardiographic findings and clinical outcomes, and the comparative efficacy and safety of apixaban and warfarin for each finding. Patients from the ARISTOTLE trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) with SEC, LA/LAA thrombus, or CAP diagnosed by either transthoracic or transesophageal echocardiography were compared with patients with none of these findings on transesophageal echocardiography. A total of 1251 patients were included: 217 had SEC, 127 had LA/LAA thrombus, 241 had CAP, and 746 had none. The rates of stroke/systemic embolism were not significantly different among patients with and without these echocardiographic findings (hazard ratio, 0.96; 95% confidence interval, 0.25-3.60 for SEC; hazard ratio, 1.27; 95% confidence interval, 0.23-6.86 for LA/LAA thrombus; hazard ratio, 2.21; 95% confidence interval, 0.71-6.85 for CAP). Rates of ischemic stroke, myocardial infarction, ca...Continue Reading

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Citations

Jul 29, 2019·Current Cardiology Reports·Pooja S Jagadish, Rajesh Kabra
Jan 1, 2021·European Heart Journal Supplements : Journal of the European Society of Cardiology·Deirdre A Lane, Gregory Y H Lip
Mar 13, 2021·European Heart Journal Cardiovascular Imaging·Ariel CohenUNKNOWN chair of the 2018–2020 EACVI Scientific Documents Committee
Apr 17, 2021·Journal of the Neurological Sciences·Jean Jacques NoubiapPrashanthan Sanders
Dec 21, 2019·JACC. Clinical Electrophysiology·Christopher R Ellis
Aug 27, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Julian Felix BackhausMichael Gotzmann

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