scholarly journals P3830Favorable neurological outcomes of left atrial appendage occlusion versus non-vitamin K antagonist oral anticoagulants after stroke in atrial fibrillation

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
O Lee ◽  
K Kim ◽  
J Kim ◽  
Y D Kim ◽  
H Pak ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Atrial Appendage ◽  
Neurological Outcomes ◽  
Left Atrial Appendage Occlusion

scholarly journals Outcomes of left atrial appendage occlusion vs. non-vitamin K antagonist oral anticoagulants in atrial fibrillation

2022 ◽  
Author(s):  
Wern Yew Ding ◽  
José Miguel Rivera-Caravaca ◽  
Elnara Fazio-Eynullayeva ◽  
Paula Underhill ◽  
Dhiraj Gupta ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Atrial Appendage ◽  
Research Network ◽  
Suitable Alternative ◽  
Left Atrial Appendage Occlusion

Abstract Background The effects of left atrial appendage (LAA) occlusion compared to non-vitamin K antagonist oral anticoagulant (NOAC) therapy in patients with atrial fibrillation (AF) remain unknown. Aims We aimed to evaluate the outcomes in patients with AF who received LAA occlusion vs. NOAC therapy. Methods We utilised data from TriNetX which is a global federated health research network currently containing data for 88.5 million patients. ICD-10 codes were employed to identify AF patients treated with either LAA occlusion or NOAC between 1st December 2010 and 17th January 2019. Clinical outcomes of interest were analysed up to 2 years. Results 108,697 patients were included. Patients who underwent LAA occlusion were younger, more likely to be white Caucasian and male, had a greater incidence of comorbidities, and were less likely to be prescribed other cardiovascular medications. Using propensity score matching, the risk of all-cause mortality was significantly lower among patients who received LAA occlusion compared to NOAC therapy [1.51% vs. 5.60%, RR 0.27 (95% CI 0.14–0.54)], but there were no statistical differences in the composite thrombotic or thromboembolic events [8.17% vs. 7.72%, RR 1.06 (95% CI 0.73–1.53)], ischaemic stroke or TIA [4.69% vs. 5.45%, RR 0.86 (95% CI 0.54–1.38)], venous thromboembolism [1.66% vs. 1.51%, RR 1.10 (95% CI 0.47–2.57)] and intracranial haemorrhage [1.51% vs. 1.51%, RR 1.00 (95% CI 0.42–2.39)]. Conclusion Overall, LAA occlusion might be a suitable alternative to NOAC therapy for stroke prevention in patients with AF. Graphical abstract

scholarly journals Does the CHA2DS2-VASc scale sufficiently predict the risk of left atrial appendage thrombus in patients with diagnosed atrial fibrillation treated with non-vitamin K oral anticoagulants?

Medicine ◽  
2020 ◽  
Vol 99 (25) ◽  
pp. e20570
Author(s):  
Anna Michalska ◽  
Iwona Gorczyca ◽  
Magdalena Chrapek ◽  
Agnieszka Kapłon-Cieślicka ◽  
Beata Uziębło-Życzkowska ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Oral Anticoagulants ◽  
Atrial Appendage ◽  
Left Atrial Appendage Thrombus

scholarly journals Percutaneous left atrial appendage occlusion in nonvalvular atrial fibrillation patients with coronary heart disease

2020 ◽  
Author(s):  
Juan Zhang ◽  
Xiaomin Jiang ◽  
Dujiang Xie ◽  
Jie Luo ◽  
Ling Zhou
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Oral Anticoagulants ◽  
Atrial Appendage ◽  
Nonvalvular Atrial Fibrillation ◽  
End Point ◽  
Left Atrial Appendage Occlusion

Abstract Purpose To evaluate the 12-month outcomes of the percutaneous left atrial appendage occlusion (LAAO) procedure in nonvalvular atrial fibrillation (NVAF) patients with coronary heart disease (CAD). Materials and Methods 51 NVAF patients were consecutively accepted LAAO between June 2015 and July 2017. Patients were devided in two groups: 15 with CAD and 36 without CAD. All patients were followed up at 1st, 3rd, 6th, and 12th month after discharge with transesophageal echocardiography (TEE) examination repeated at the same time. Results Among these 51 patients (average age 64.4±10.0, 33.3% female), the procedural success rate was 98% (50/51). During 12-month follow-up, there were no hemorrhagic stroke or major bleeding. The risk of thromboembolism based on CHA2DS2-VASc score (3.1±1.6 vs. 5.2±1.1, P<0.001) and the risk of hemorrhage based on HAS-BLED score (2.2±1.2 vs. 3.1±1.0, P=0.009) in CAD group were significantly higher. The incidence of end-point events had no statistical difference between CAD and non-CAD. Compared with CAD patients who accepted long-term antithrombotic medication, there was no obvious difference in stroke rate and mortality in CAD accepted LAAO group, whereas a further reduction of hemorrhage (n=5/20% vs. n=0, P=0.039) was shown. A significant correlation (P<0.001, r=0.580) was detected between moderate or severe left atrial spontaneous echo contrast (LASEC) and the composite end point events. Conclusion There are similar safety and effectiveness for LAAO procedure in NVAF patients with CAD and without CAD under new oral anticoagulants applied post-implantation anticoagulation strategy. Meanwhile, LASEC is a predictive factor of LAAO in NVAF patients combined CAD.

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