Evidence map›Paper›PMID 38515032›Full record

SynthesisBMC cardiovascular disorders2024

Overcoming barriers for left atrial appendage thrombus: a systematic review of left atrial appendage closure.

Zixi Zhang, Jiabao Zhou, Qiuzhen Lin, Cancan Wang, Yunying Huang, Yongguo Dai, Wanyun Zuo, Na Liu, Yichao Xiao, Qiming Liu

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in BMC cardiovascular disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.0field-weighted citation impact, top 13% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

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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

10 authors at 3 institutions in 1 country.

Zixi Zhang *Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Hunan Province, Changsha, 410011, People's Republic of China.
Jiabao Zhou *Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Hunan Province, Changsha, 410011, People's Republic of China.
Qiuzhen LinDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Hunan Province, Changsha, 410011, People's Republic of China.
Cancan WangDepartment of Metabolic Endocrinology, The Second Xiangya Hospital, Central South University, Hunan Province, Changsha, 410011, People's Republic of China.
Yunying HuangDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Hunan Province, Changsha, 410011, People's Republic of China.
Yongguo DaiDepartment of Pharmacology, Wuhan University TaiKang Medical School (School of Basic Medical Sciences), Hubei Province, Wuhan, 430071, People's Republic of China.
Wanyun ZuoDepartment of Hematology, The Second Xiangya Hospital, Central South University, Hunan Province, Changsha, 410011, People's Republic of China.
Na LiuDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Hunan Province, Changsha, 410011, People's Republic of China.
Yichao XiaoDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Hunan Province, Changsha, 410011, People's Republic of China. yichaoxiao@csu.edu.cn.
Qiming LiuDepartment of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Hunan Province, Changsha, 410011, People's Republic of China. qimingliu@csu.edu.cn.
Second Xiangya Hospital of Central South University · CNCentral South University · CNWuhan University · CN

Funding

Changsha Municipal Natural Science Foundation kq2208306Clinical Medical Technology Innovation Guidance Project of Hunan Science and Technology Agency 2021SK53519Hunan Provincial Health Commission Scientific Research Project 20201302Hunan Provincial Natural Science Foundation of China 2021JJ30033Key Project of Hunan Provincial Science and Technology Innovation 2020SK1013National Natural Science Foundation of China 82070356National Natural Science Foundation of China 82200068
6 · The paper itself

Abstract

backgroundApproximately 90% of intracardial thrombi originate from the left atrial appendage in non-valvular atrial fibrillation patients. Even with anticoagulant therapy, left atrial appendage thrombus (LAAT) still occurs in 8% of patients. While left atrial appendage closure (LAAC) could be a promising alternative, the current consensus considers LAAT a contraindication to LAAC. However, the feasibility and safety of LAAC in patients with LAAT have yet to be determined.

methodsThis systematic review synthesizes published data to explore the feasibility and safety of LAAC for patients with LAAT.

resultsThis study included a total of 136 patients with LAATs who underwent successful LAAC. The Amulet Amplatzer device was the most frequently utilized device (48.5%). Among these patients, 77 (56.6%) had absolute contraindications to anticoagulation therapy. Cerebral protection devices were utilized by 47 patients (34.6%). Transesophageal echocardiography (TEE) is the primary imaging technique used during the procedure. Warfarin and novel oral anticoagulants were the main anticoagulant medications used prior to the procedure, while dual antiplatelet therapy was primarily used post-procedure. During a mean follow-up period of 13.2 ± 11.5 months, there was 1 case of fatality, 1 case of stroke, 3 major bleeding events, 3 instances of device-related thrombus, and 8 cases of peri-device leakage.

conclusionsThis review highlights the preliminary effectiveness and safety of the LAAC procedure in patients with persistent LAAT. Future large-scale RCTs with varied LAAT characteristics and LAAC device types are essential for evidence-based decision-making in clinical practice.

Indexed as

AnticoagulantsAtrial AppendageAtrial FibrillationLeft Atrial Appendage ClosureThrombosisAgedAged, 80 and overContraindications, DrugEchocardiography, TransesophagealFemaleHeart DiseasesHumansMaleMiddle AgedRisk AssessmentRisk FactorsAnticoagulantsAtrial fibrillationLeft atrial appendage closureLeft atrial appendage thrombusSystematic review

Identifiers

PMID38515032
PMCPMC10956221
OpenAlexW4393040360

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.