Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Feb 26, 2019; 11(2): 84-93
Published online Feb 26, 2019. doi: 10.4330/wjc.v11.i2.84
Prevalence and clinical characteristics associated with left atrial thrombus detection: Apixaban
Hoyle L Whiteside, Arun Nagabandi, Kristen Brown, Deepak N Ayyala, Gyanendra K Sharma
Hoyle L Whiteside, Kristen Brown, Division of Internal Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, United States
Arun Nagabandi, Gyanendra K Sharma, Division of Cardiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, United States
Deepak N Ayyala, Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA 30912, United States
Author contributions: Whiteside HL wrote the manuscript; Whiteside HL, Nagabandi A and Sharma GK reviewed and revised the final version of the manuscript; Whiteside HL, Nagabandi A and Sharma GK designed the study; Whiteside HL, Nagabandi A and Brown K coordinated and provided the data collection; Ayyala DN provided statistical consultation and analysis.
Institutional review board statement: The Institutional Review Board of Augusta University reviewed and approved this study on February 8, 2017.
Informed consent statement: This study was a retrospective analysis utilizing data readily available within the electronic medical record system. The study received a waiver of the consent process upon review by the Institutional Review Board and the dataset was stored electronically on an institutional research drive.
Conflict-of-interest statement: The authors report no financial relationships or conflicts of interest regarding the content.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hoyle L Whiteside, MD, Doctor, Division of Internal Medicine, Medical College of Georgia at Augusta University, 1120 15th St., Augusta, GA30909, United States. hwhiteside@augusta.edu
Telephone: +1-706-7212423 Fax: +1-706-7211059
Received: October 24, 2018
Peer-review started: October 24, 2018
First decision: December 10, 2018
Revised: December 18, 2018
Accepted: January 8, 2019
Article in press: January 9, 2019
Published online: February 26, 2019
Processing time: 124 Days and 10.1 Hours
Core Tip

Core tip: The prevalence of left atrial appendage (LAA) thrombus detection by transesophageal echocardiogram (TEE) in patients with non-valvular atrial fibrillation (AF) anticoagulated with apixaban is not well defined and identification of additional risk factors may help guide the selection process for pre-procedural TEE. At our institution, the prevalence of thrombus detection in patients compliant with apixaban was 3.1%. Persistent AF, left ventricular ejection fraction < 30%, severe LA dilation, and reduced LAA velocity were associated with thrombus formation. Following multivariate logistic regression, persistent AF and reduced LAA velocity were identified as independent predictors of thrombus detection.