Comparison of Left Atrial Appendage Occlusion versus Non-Vitamin-K Antagonist Oral Anticoagulation in High-Risk Atrial Fibrillation: An Update.
anticoagulation
atrial fibrillation
left atrial appendage occlusion
stroke
Journal
Journal of cardiovascular development and disease
ISSN: 2308-3425
Titre abrégé: J Cardiovasc Dev Dis
Pays: Switzerland
ID NLM: 101651414
Informations de publication
Date de publication:
11 Jun 2021
11 Jun 2021
Historique:
received:
16
05
2021
revised:
03
06
2021
accepted:
09
06
2021
entrez:
2
7
2021
pubmed:
3
7
2021
medline:
3
7
2021
Statut:
epublish
Résumé
Transcatheter left atrial appendage occlusion (LAAO) is non-inferior to vitamin K antagonists (VKAs) in preventing thromboembolic events in atrial fibrillation (AF). Non-vitamin K antagonists (NOACs) have an improved safety profile over VKAs; however, evidence regarding their effect on cardiovascular and neurological outcomes relative to LAAO is limited. Up-to-date randomized trials or propensity-score-matched data comparing LAAO vs. NOACs in high-risk patients with AF were pooled in our study. A total of 2849 AF patients (LAAO: 1368, NOACs: 1481, mean age: 75 ± 7.5 yrs, 63.5% male) were enrolled. The mean CHA2DS2-VASc score was 4.3 ± 1.7, and the mean HAS-BLED score was 3.4 ± 1.2. The baseline characteristics were comparable between the two groups. In the LAAO group, the success rate of device implantation was 98.8%. During a mean follow-up of 2 years, as compared with NOACs, LAAO was associated with a significant reduction of ISTH major bleeding (
Identifiants
pubmed: 34208117
pii: jcdd8060069
doi: 10.3390/jcdd8060069
pmc: PMC8230807
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
J Am Coll Cardiol. 2017 Dec 19;70(24):2964-2975
pubmed: 29103847
EuroIntervention. 2020 Apr 17;15(17):1548-1554
pubmed: 31845892
N Engl J Med. 2011 Sep 15;365(11):981-92
pubmed: 21870978
Stroke. 2018 Jun;49(6):1464-1470
pubmed: 29739915
J Am Coll Cardiol. 2020 Jun 30;75(25):3122-3135
pubmed: 32586585
Can J Cardiol. 2016 Nov;32(11):1355.e9-1355.e14
pubmed: 27432692
JACC Cardiovasc Interv. 2021 Jan 11;14(1):69-78
pubmed: 33413867
N Engl J Med. 2009 Sep 17;361(12):1139-51
pubmed: 19717844
JACC Clin Electrophysiol. 2019 Mar;5(3):398-400
pubmed: 30898245
JACC Clin Electrophysiol. 2020 Dec 14;6(13):1633-1642
pubmed: 33334441
J Cardiol. 2019 Apr;73(4):299-306
pubmed: 30583991
J Cardiovasc Electrophysiol. 2020 Jan;31(1):247-249
pubmed: 31749201
Circulation. 2012 Nov 13;126(20):2381-91
pubmed: 23071159
Eur Heart J. 2021 Feb 1;42(5):373-498
pubmed: 32860505
N Engl J Med. 2013 Nov 28;369(22):2093-104
pubmed: 24251359
Europace. 2019 Oct 1;21(10):1502-1508
pubmed: 31230078
J Cardiovasc Electrophysiol. 2018 Feb;29(2):291-297
pubmed: 29149516
N Engl J Med. 2011 Sep 8;365(10):883-91
pubmed: 21830957
Card Electrophysiol Clin. 2020 Mar;12(1):125-130
pubmed: 32067642
Expert Rev Cardiovasc Ther. 2018 Sep;16(9):675-678
pubmed: 30095350
Eur Heart J. 2020 Aug 7;41(30):2894-2901
pubmed: 32243499