Evidence map›Paper›PMID 41079579›Full record

ReviewFrontiers in cardiovascular medicine2025

Overcoming NOAC-resistant left atrial appendage thrombus in atrial fibrillation: clinical gaps and therapeutic insights.

Klaudia Vivien Nagy, Bence Arnóth, Ferenc Komlósi, László Gellér, Béla Merkely

Abstract readReview
In one paragraph

Review in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

5 authors.

Klaudia Vivien Nagy *Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Bence Arnóth *Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Ferenc KomlósiHeart and Vascular Center, Semmelweis University, Budapest, Hungary.
László GellérHeart and Vascular Center, Semmelweis University, Budapest, Hungary.
Béla MerkelyHeart and Vascular Center, Semmelweis University, Budapest, Hungary.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Atrial fibrillation (AF) is the most common supraventricular arrhythmia and a major cause of stroke and systemic embolism. The left arial appendage (LAA) is the predominant site of thrombus formation in AF. According to current guidelines, oral anticoagulant (OAC) therapy is recommended in patients with elevated thromboembolic risk. Non-vitamin K antagonist oral anticoagulants (NOACs) are currently preferred over Vitamin K antagonists (VKAs) due to favorable safety profiles. Nevertheless, a subset of patients develop LAA thrombi despite optimal anticoagulant therapy, a clinical scenario not addressed by current guidelines. Recent retrospective studies, including our own cohort analysis, suggest, that modifying antithrombotic regimen may improve thrombus resolution in these cases. However, no prospective trials have yet defined the optimal strategy. This mini-review summarizes the available evidence, highlights the limitations of current practice, and proposes directions for future research in this underrecognized clinical dilemma.

Indexed as

antithrombotic strategyatrial fibrillationleft atrial appendage thrombusNOAC resistanceoral anticoagulationVKA therapy

Identifiers

PMID41079579
PMCPMC12510914

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Registered trials

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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.