Left atrial appendage closure in patients with a reduced left ventricular ejection fraction: results from the multicenter German LAARGE registry.
Aged
Aged, 80 and over
Atrial Appendage
/ diagnostic imaging
Atrial Fibrillation
/ physiopathology
Cardiac Surgical Procedures
/ methods
Female
Follow-Up Studies
Germany
Humans
Male
Prospective Studies
Registries
Septal Occluder Device
Stroke Volume
/ physiology
Treatment Outcome
Ventricular Function, Left
/ physiology
Atrial fibrillation
Bleeding risk
Depressed left ventricular function
Ischemic stroke
LAA closure
LAARGE
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
23
10
2019
accepted:
04
03
2020
pubmed:
3
4
2020
medline:
11
8
2021
entrez:
3
4
2020
Statut:
ppublish
Résumé
Interventional left atrial appendage closure (LAAC) effectively prevents thromboembolic events in atrial fibrillation patients. Impaired left ventricular ejection fraction (LVEF) increases not only the thromboembolic risk but also the complication rates of cardiac interventions. The LAAC procedure's benefit in patients with an impaired LVEF, therefore, has yet to be investigated. LAARGE is a prospective, non-randomized registry depicting the clinical reality of LAAC in Germany. Procedure was conducted with different standard commercial devices, and follow-up period was one year. In the sense of an as-treated analysis, patients with started procedure and documented LVEF were selected from the whole database. 619 patients from 37 centers were categorized into one of three groups: LVEF > 55% (56%), 36-55% (36%), and ≤ 35% (8%). Prevalence of cardiovascular comorbidity increased with LVEF reduction (p < 0.001 for trend). CHA LVEF reduction neither influenced the procedural success nor the effectiveness and safety of stroke prevention by LAAC. ClinicalTrials.gov Identifier: NCT02230748.
Sections du résumé
BACKGROUND
BACKGROUND
Interventional left atrial appendage closure (LAAC) effectively prevents thromboembolic events in atrial fibrillation patients. Impaired left ventricular ejection fraction (LVEF) increases not only the thromboembolic risk but also the complication rates of cardiac interventions. The LAAC procedure's benefit in patients with an impaired LVEF, therefore, has yet to be investigated.
METHODS
METHODS
LAARGE is a prospective, non-randomized registry depicting the clinical reality of LAAC in Germany. Procedure was conducted with different standard commercial devices, and follow-up period was one year. In the sense of an as-treated analysis, patients with started procedure and documented LVEF were selected from the whole database.
RESULTS
RESULTS
619 patients from 37 centers were categorized into one of three groups: LVEF > 55% (56%), 36-55% (36%), and ≤ 35% (8%). Prevalence of cardiovascular comorbidity increased with LVEF reduction (p < 0.001 for trend). CHA
CONCLUSIONS
CONCLUSIONS
LVEF reduction neither influenced the procedural success nor the effectiveness and safety of stroke prevention by LAAC.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov Identifier: NCT02230748.
Identifiants
pubmed: 32236717
doi: 10.1007/s00392-020-01627-8
pii: 10.1007/s00392-020-01627-8
pmc: PMC7588387
doi:
Banques de données
ClinicalTrials.gov
['NCT02230748']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1333-1341Références
JACC Cardiovasc Interv. 2013 Jun;6(6):606-13
pubmed: 23787233
Heart Fail Rev. 2014 May;19(3):305-13
pubmed: 24445936
Eur Heart J. 2016 Aug;37(31):2465-74
pubmed: 26822918
EuroIntervention. 2016 May 17;12(1):103-11
pubmed: 27173870
Lancet. 2009 Aug 15;374(9689):534-42
pubmed: 19683639
Clin Res Cardiol. 2019 Dec;108(12):1406-1407
pubmed: 30989317
Am J Cardiol. 2003 Mar 20;91(6A):2D-8D
pubmed: 12670636
Chest. 2010 Feb;137(2):263-72
pubmed: 19762550
Ann Pharmacother. 2014 Feb;48(2):226-37
pubmed: 24259641
EuroIntervention. 2016 Feb;11(10):1170-9
pubmed: 25604089
Prog Cardiovasc Dis. 2015 Sep-Oct;58(2):126-35
pubmed: 26192885
EuroIntervention. 2018 Jun 20;14(2):151-157
pubmed: 29508766
Eur J Heart Fail. 2018 Mar;20(3):598-608
pubmed: 28834079
Eur Heart J. 2016 Oct 7;37(38):2893-2962
pubmed: 27567408
Clin Res Cardiol. 2017 Aug;106(8):618-628
pubmed: 28293797
JAMA. 2014 Nov 19;312(19):1988-98
pubmed: 25399274
Am J Cardiol. 2012 Feb 1;109(3):344-51
pubmed: 22112742
Clin Res Cardiol. 2017 Dec;106(12):1018-1025
pubmed: 28828679
Heart. 2012 Aug;98(15):1120-6
pubmed: 22572045
J Am Coll Cardiol. 2014 Jul 8;64(1):1-12
pubmed: 24998121