Evidence map›Paper›PMID 35849447›Full record

Observational studyScience progress

Risk of device-related thrombosis following short-term oral anticoagulation with low-dose dabigatran versus warfarin after Watchman left atrial appendage occlusion.

Heng Ge, Chi Zhang, Zhi-Qing Qiao, Zi-Yong Hao, Zheng Li, Zhi-Chun Gu, Li-Sheng Jiang, Ben He, Jun Pu

Open access · diamondAbstract readObservational Study
In one paragraph

Observational study in Science progress. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 3 pooled it
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 syntheses or guidelines pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Heng GeDepartment of Cardiology, Ren Ji Hospital, 71140Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Chi ZhangDepartment of Pharmacy, Ren Ji Hospital, 71140Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Zhi-Qing QiaoDepartment of Cardiology, Ren Ji Hospital, 71140Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Zi-Yong HaoDepartment of Cardiology, Ren Ji Hospital, 71140Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Zheng LiDepartment of Cardiology, Ren Ji Hospital, 71140Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Zhi-Chun GuDepartment of Pharmacy, Ren Ji Hospital, 71140Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID 0000-0002-1245-9690
Li-Sheng JiangDepartment of Cardiology, 71141Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Ben HeDepartment of Cardiology, 71141Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Jun PuDepartment of Cardiology, Ren Ji Hospital, 71140Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Jiao Tong University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPercutaneous left atrial appendage occlusion (LAAO) provides an alternative for poor candidates for long-term oral anticoagulation (OAC). To prevent device-related thrombosis (DRT), OAC should be continued for the first 45 days to allow complete endothelialization post-LAAO implantation. Whereas, evidence is limited on the feasibility and safety of direct oral anticoagulants (DOACs) used after LAAO.

methodsThis was a retrospective observational single-center study of AF patients undergoing LAAO with a Watchman device and receiving either low-dose dabigatran (110mg twice daily) or warfarin in the peri- and post-procedural period for 45 days. Transesophageal echocardiography was scheduled to perform at 6 weeks, 6 months, and 12 months after the procedure to assess the stability of the device and to detect DRT. Incidence of thromboembolic and bleeding events were also evaluated during the follow-up period.

resultsThere were a total of 84 patients who successfully underwent Watchman implantation, with 38 patients (45.2%) receiving low-dose dabigatran and 46 patients (54.8%) using warfarin post-LAAO. Peri-procedural complications occurred in 10 patients, with 3 patients in the dabigatran group and 7 patients in the warfarin group (7.9% vs. 15.2%,

conclusionsThis study suggested that short-term low-dose dabigatran (110 mg twice daily) could significantly decrease the risk of bleeding compared with warfarin at the expense of increased risk of DRT post-LAAO. Therefore, low-dose dabigatran should be used with caution for post-implant anticoagulation of LAAO. Further studies are urgently needed on the feasibility and safety of DOACs post-LAAO.

Indexed as

Atrial AppendageAtrial FibrillationThrombosisAnticoagulantsDabigatranHemorrhageHumansTreatment OutcomeWarfarinAnticoagulantsDabigatranWarfarinatrial fibrillationdabigatrandevice-related thrombosisLeft atrial appendage occlusionreduced-dose

Identifiers

PMID35849447
PMCPMC10450492
OpenAlexW4285795864

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.