Why the study?
Evidence for managing left atrial appendage thrombus in patients already on therapeutic anticoagulation with apixaban was limited.
Does the addition of clopidogrel to apixaban improve left atrial appendage thrombus resolution in patients with atrial fibrillation who fail apixaban monotherapy?
Does the addition of clopidogrel to apixaban improve left atrial appendage thrombus resolution in patients with atrial fibrillation who fail apixaban monotherapy?
The addition of clopidogrel to apixaban may offer a novel, effective strategy for accelerating the resolution of left atrial appendage thrombi in patients who fail DOAC monotherapy.
Hypothesis-generating for clopidogrel addition in apixaban-refractory LAA thrombus; prospective trials needed before clinical adoption.
This hypothesis-generating, case series reviews the evidence available for managing left atrial appendage thrombus in patients already on therapeutic anticoagulation with apixaban. Our six patient cases highlight the first documented evidence of complete, accelerated clot resolution upon the addition of P2Y12 inhibitor, clopidogrel, to current therapeutic doses of apixaban.
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P et al. (2022) studied this question.
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