{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T19:17:13Z","timestamp":1778527033864,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,10,14]],"date-time":"2015-10-14T00:00:00Z","timestamp":1444780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The use of oral anticoagulation or dual antiplatelet therapy (<jats:styled-content style=\"fixed-case\">DAPT<\/jats:styled-content>) is recommended within the first 45 days after left atrial appendage (<jats:styled-content style=\"fixed-case\">LAA<\/jats:styled-content>) closure using the Watchman device because of incomplete device endothelialization. This study reports for the first time the feasibility of novel oral anticoagulants (<jats:styled-content style=\"fixed-case\">NOAC<\/jats:styled-content>) in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>NOAC therapy is safe and effective after LAA closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Interventional <jats:styled-content style=\"fixed-case\">LAA<\/jats:styled-content> closure was performed successfully in 45 patients. Of these, 18 patients received <jats:styled-content style=\"fixed-case\">NOAC<\/jats:styled-content> during the first 45 days after implantation and 27 patients received <jats:styled-content style=\"fixed-case\">DAPT<\/jats:styled-content>. Transesophageal echocardiography was conducted 45 days after implantation. The primary study endpoint was abnormal thrombus apposition 45 days after implantation. Secondary study endpoints were death from any cause, major adverse cardiac and cerebrovascular events (<jats:styled-content style=\"fixed-case\">MACCE<\/jats:styled-content>), and major bleedings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After 45 days, transesophageal echocardiography revealed no abnormal thrombus apposition. During a follow\u2010up of 417 \u00b1 323 days, 7 patients died. No stroke or transient ischemic attack occurred. Nonfatal myocardial infarction occurred in 1 patient. There was a nonsignificant trend for lower all\u2010cause mortality (<jats:italic>P<\/jats:italic> = 0.159) and occurrence of <jats:styled-content style=\"fixed-case\">MACCE<\/jats:styled-content> (<jats:italic>P<\/jats:italic> = 0.096) in the <jats:styled-content style=\"fixed-case\">NOAC<\/jats:styled-content> group compared with the <jats:styled-content style=\"fixed-case\">DAPT<\/jats:styled-content> group. Overall, 6 patients suffered from a major bleeding (<jats:styled-content style=\"fixed-case\">NOAC<\/jats:styled-content>, n = 3; <jats:styled-content style=\"fixed-case\">DAPT<\/jats:styled-content>, n = 3). In <jats:styled-content style=\"fixed-case\">NOAC<\/jats:styled-content> group, major bleedings (at day 205, 688, and 736) occurred long after termination of <jats:styled-content style=\"fixed-case\">NOAC<\/jats:styled-content> therapy. There was no significant difference in the frequency of major bleedings in different groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our pilot study suggests that <jats:styled-content style=\"fixed-case\">NOAC<\/jats:styled-content> therapy within the first 45 days after interventional <jats:styled-content style=\"fixed-case\">LAA<\/jats:styled-content> closure is safe and effective.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22478","type":"journal-article","created":{"date-parts":[[2015,10,15]],"date-time":"2015-10-15T09:05:42Z","timestamp":1444899942000},"page":"720-724","source":"Crossref","is-referenced-by-count":33,"title":["Initial Experience With Novel Oral Anticoagulants During the First 45 Days After Left Atrial Appendage Closure With the Watchman Device"],"prefix":"10.1002","volume":"38","author":[{"given":"Leif I.","family":"B\u00f6sche","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil Ruhr\u2010University Bochum  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faegheh","family":"Afshari","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil Ruhr\u2010University Bochum  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Sch\u00f6ne","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil Ruhr\u2010University Bochum  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aydan","family":"Ewers","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil Ruhr\u2010University Bochum  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"M\u00fcgge","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil Ruhr\u2010University Bochum  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Gotzmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil Ruhr\u2010University Bochum  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.11.030"},{"key":"e_1_2_6_3_1","first-page":"1998","article-title":"PROTECT\u2010AF Steering Committee and Investigators. 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