Key result
NOACs match VKAs for preventing left atrial thrombus in non-valvular atrial fibrillation.
Why the study?
Data were limited regarding the efficacy of NOACs compared with VKAs in preventing left atrial thrombus formation before cardioversion or catheter ablation in patients with non-valvular atrial fibrillation.
Do NOACs prevent left atrial thrombus formation as effectively as VKAs in patients with non-valvular atrial fibrillation?
Meta-Analysis
Do NOACs prevent left atrial thrombus formation as effectively as VKAs in patients with non-valvular atrial fibrillation?
Effect estimate: OR 0.79 (95% CI 0.52-1.21)
p-value: p=.29
NOACs are as effective as VKAs in preventing left atrial thrombus formation in patients with non-valvular atrial fibrillation prior to cardioversion or catheter ablation.
NOACs appear comparable to VKAs for left atrial thrombus prevention in nonvalvular AF; extends mostly observational data but leaves definitive RCT confirmation open.
BACKGROUND: There is still a paucity of data on the efficacy of non-vitamin K antagonist oral anticoagulants (NOACs) in the prevention of left atrial thrombus (LAT) formation before cardioversion or catheter ablation. To assess the efficacy of NOACs in the prevention of LAT in patients with non-valvular atrial fibrillation (NVAF) compared with vitamin K antagonists (VKAs), we conducted a meta-analysis. METHODS: We searched PubMed, Embase, and the Cochrane Library databases. For meta-analysis, dichotomous variables were analyzed by using the odds ratios (OR) computed using the Mantel Haenszel method (random models). All results were reported with 95% confidence intervals (CI). RESULTS: A total of 13 studies (one randomized controlled investigation and 12 observational studies) were included in the meta-analysis. There was no statistically significant difference between the NOACs and VKAs groups with respect to the odds of LAT/LAAT formations (OR 0.79; 95% CI: 0.52-1.21; P = .29; (I2 = 14%). CONCLUSIONS: NOACs were as effective as VKAs in the prevention of LAT/LAAT formation in patients with NVAF. Though patients on NOACs therapy showed a lower incidence of LAT/LAAT formation compared with VKAs, it was not significant (P = .29).
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Liu et al. (2020) conducted a meta-analysis in Non-valvular atrial fibrillation (NVAF). Non-vitamin K antagonist oral anticoagulants (NOACs) vs. Vitamin K antagonists (VKAs) was evaluated on Left atrial thrombus (LAT) or left atrial appendage thrombus (LAAT) formation (OR 0.79, 95% CI 0.52-1.21, p=.29). NOACs were as effective as vitamin K antagonists in preventing left atrial thrombus formation in patients with non-valvular atrial fibrillation (OR 0.79; 95% CI 0.52-1.21; P=.29).
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