What question did this study set out to answer?

This study aims to evaluate how renal function and the dosage of non-vitamin K antagonist oral anticoagulants (NOACs) affect the risk of left atrial thrombus (LAT) in patients with atrial fibrillation.

January 10, 2026Kardiologia Polska0 citationsOpen Access

Influence of renal function and dose of non-vitamin K antagonist oral anticoagulants on left atrial thrombus risk in patients with atrial fibrillation. Results from the multicenter LATTEE study

MGMonika Gawałko MBMonika Budnik PŚPiotr ŚcisłoMedical University of Warsaw

Key Result

Patients with atrial fibrillation and CrCl <50 ml/min face a doubled left atrial thrombus risk when receiving inappropriate NOAC doses, especially with apixaban and rivaroxaban.

Key Points

This study aims to evaluate how renal function and the dosage of non-vitamin K antagonist oral anticoagulants (NOACs) affect the risk of left atrial thrombus (LAT) in patients with atrial fibrillation.
Evaluated atrial fibrillation patients with varying levels of renal function
Assessed the impact of different NOAC doses on LAT risk
Analyzed data from the multicenter LATTEE study
Patients with renal function (CrCl) <50 ml/min have a doubled risk of LAT despite receiving oral anticoagulation (OAC) therapy
Inappropriate dosing of NOACs, particularly apixaban and rivaroxaban, significantly increases LAT risk

Structured PICO

Does renal dysfunction and inappropriate NOAC dosing increase the risk of left atrial thrombus in patients with atrial fibrillation?

Population

2,790 hospitalized patients with atrial fibrillation (AF) or atrial flutter (AFl) undergoing transesophageal echocardiography (TEE) prior to cardioversion or ablation, with available creatinine clearance (CrCl) data.

Intervention

Renal dysfunction (CrCl <50 ml/min) and inappropriate non-vitamin K antagonist oral anticoagulant (NOAC) dosing (specifically inappropriate dose reductions).

Comparator

Normal renal function (CrCl ≥50 ml/min) and appropriate NOAC dosing.

Outcome

Prevalence of left atrial thrombus (LAT) in patients with AF/AFl, in whom TEE was performed before AF/AFl cardioversion or ablation.surrogate

Renal dysfunction and inappropriate NOAC dose reductions significantly increase the risk of left atrial thrombus in patients with atrial fibrillation, highlighting the need for strict guideline adherence and potentially incorporating renal function into risk scores.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

AF patients with CrCl <50 ml/min face a doubled LAT risk despite OAC therapy. Inappropriate NOAC dosing, particularly with apixaban and rivaroxaban, leads to double LAT risk.

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