Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
Department of Cardiology, People's Hospital of Guilin, Guilin, China.
J Thromb Thrombolysis. 2019 Aug;48(2):270-276. doi: 10.1007/s11239-019-01876-z.
Data on LA/LAA thrombus resolution after rivaroxaban treatment has not been established. The aim of the present study was to compare the efficacy and safety on the resolution of LA/LAA thrombus between rivaroxaban and warfarin in nonvalvular atrial fibrillation (AF) patients. 80 AF patients with LA/LAA thrombus between January 2013 and June 2016 were randomized divided into warfarin group (n = 40) and rivaroxaban group (n = 40). Compared to warfarin group, thrombin time (TT; p < 0.0001), plasma prothrombin time (PT; p < 0.0001), and activated partial thromboplastin time (APTT; p = 0.0019) were significantly lower, and fibrinogen (FIB; p < 0.0001) was significantly higher in rivaroxaban group. TEE shown the average length (p < 0.0001), average width (p = 0.0008) and average area (p < 0.0001) of thrombus were significantly lower in rivaroxaban group compared to warfarin group after 6-week treatments. No major or fatal bleeding and ischemic stroke occurred in both two groups. The 20 mg dose Rivaroxaban is more effective than warfarin on the resolution of LA/LAA thrombus in nonvalvular AF patients especially after 6-week treatments. The results suggest that rivaroxaban is a potential option for the treatment of LA/LAA thrombus in patients with nonvalvular AF.
尚未确定利伐沙班治疗后左心房/左心耳（LA/LAA）血栓的溶解数据。本研究旨在比较非瓣膜性心房颤动（AF）患者中利伐沙班和华法林在 LA/LAA 血栓溶解方面的疗效和安全性。2013 年 1 月至 2016 年 6 月期间，80 例 LA/LAA 血栓的 AF 患者被随机分为华法林组（n = 40）和利伐沙班组（n = 40）。与华法林组相比，利伐沙班组的凝血酶时间（TT；p < 0.0001）、血浆凝血酶原时间（PT；p < 0.0001）和活化部分凝血活酶时间（APTT；p = 0.0019）显著降低，纤维蛋白原（FIB；p < 0.0001）显著升高。TEE 显示，与华法林组相比，利伐沙班组治疗 6 周后血栓的平均长度（p < 0.0001）、平均宽度（p = 0.0008）和平均面积（p < 0.0001）均显著降低。两组均未发生大出血或致命性出血和缺血性卒中。20mg 剂量的利伐沙班在非瓣膜性 AF 患者中对 LA/LAA 血栓的溶解作用优于华法林，尤其是在治疗 6 周后。结果表明，利伐沙班是治疗非瓣膜性 AF 患者 LA/LAA 血栓的一种潜在选择。
