{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:57:40Z","timestamp":1791496660819,"version":"4.3.4"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>The impact of antithrombotic therapy on coagulation system activation after left atrial appendage closure (LAAC) remains unknown. This study sought to compare changes in coagulation markers associated with short-term oral anticoagulation (OAC) versus antiplatelet therapy (APT) following LAAC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Prospective study including 78 atrial fibrillation patients undergoing LAAC with the Watchman device. F1+2 (prothrombin fragment 1+2) and TAT (thrombin-antithrombin III) were assessed immediately before the procedure, and at 7, 30, and 180 days after LAAC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Forty-eight patients were discharged on APT (dual: 31, single: 17) and 30 on OAC (direct anticoagulants: 26, vitamin K antagonists: 4), with no differences in baseline-procedural characteristics between groups except for higher spontaneous echocardiography contrast in the OAC group. OAC significantly reduced coagulation activation within 7 days post-LAAC compared with APT (23% [95% CI, 5%\u201341%] versus 82% [95% CI, 54%\u2013111%] increase for F1+2,\n              <jats:italic>P<\/jats:italic>\n              =0.007; 52% [95% CI, 15%\u201389%] versus 183% [95% CI, 118%\u2013248%] increase for TAT,\n              <jats:italic>P<\/jats:italic>\n              =0.048), with all patients in both groups progressively returning to baseline values at 30 and 180 days. Spontaneous echocardiography contrast pre-LAAC was associated with an enhanced activation of the coagulation system post-LAAC (144 [48\u2013192] versus 52 [24\u2013111] nmol\/L,\n              <jats:italic>P<\/jats:italic>\n              =0.062 for F1+2; 299 [254\u2013390] versus 78 [19\u2013240] ng\/mL,\n              <jats:italic>P<\/jats:italic>\n              =0.002 for TAT). Device-related thrombosis occurred in 5 patients (6.4%), and all of them were receiving APT at the time of transesophageal echocardiography (10.2% versus 0% if OAC at the time of transesophageal echocardiography,\n              <jats:italic>P<\/jats:italic>\n              =0.151). Patients with device thrombosis exhibited a greater coagulation activation 7 days post-LAAC (\n              <jats:italic>P<\/jats:italic>\n              =0.038 and\n              <jats:italic>P<\/jats:italic>\n              =0.108 for F1+2 and TAT, respectively).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>OAC (versus APT) was associated with a significant attenuation of coagulation system activation post-LAAC. Spontaneous echocardiography contrast pre-LAAC associated with enhanced coagulation activation post-LAAC, which in turn increased the risk of device thrombosis. These results highlight the urgent need for randomized trials comparing OAC versus APT post-LAAC.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.120.009039","type":"journal-article","created":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T09:00:16Z","timestamp":1597050016000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Short-Term Oral Anticoagulation Versus Antiplatelet Therapy Following Transcatheter Left Atrial Appendage Closure"],"prefix":"10.1161","volume":"13","author":[{"given":"Lluis","family":"Asmarats","sequence":"first","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"O\u2019Hara","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Champagne","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Paradis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Bernier","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Beaudoin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Junquera","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Del Val","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillem","family":"Muntan\u00e9-Carol","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e9lanie","family":"C\u00f4t\u00e9","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8237-7095","authenticated-orcid":true,"given":"Josep","family":"Rod\u00e9s-Cabau","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, 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