Arrhythmias & electrophysiology
Low-Dose Direct Oral Anticoagulation vs Dual Antiplatelet Therapy After Left Atrial Appendage Occlusion: The ADALA Randomized Clinical Trial
Primary resultResult — go to the resultHazard ratio 0.19 95% CI 0.04–0.88- prematurely terminated (60% of estimated sample size)
Authors' conclusion
Results show that use of low-dose DOAC for 3 months after LAAO was associated with a better balance between efficacy and safety compared with DAPT.
Study context
- Population
- Patients after successful percutaneous left atrial appendage occlusion (LAAO)included in the analysis
- Participants
- 90 patients
- Comparison
- Low-dose DOAC vs dual antiplatelet therapy (DAPT) for 3 months after LAAO
- Low-dose DOACn = 44
- DAPTn = 46reference
- Primary endpoint
- Composite of:
- Major bleeding
- Thromboembolic events (stroke, systemic embolism, device-related thrombosis)
- Follow-up
- 3 months after successful LAAO
Methodological detailsinvestigator-initiated, multicentre, prospective, open-label, 3 European sites
- Investigator-initiated
- Multicentre
- Prospective
- Open-label
- 3 European sites
Primary result
As reported in the abstract
3 months
Hazard ratio
0.19
95% CI 0.04–0.88
P = 0.02
Events by treatment group
Low-dose DOAC vs DAPT
HR 0.19 (95% CI 0.04–0.88); P = 0.02
Secondary outcomes
Device-related thrombosis
- Device-related thrombosis: P = .04
Stroke and systemic embolism
- None in the overall population
- 0
Safety
Major bleeding
- Major bleeding: P = .17
Original publication
Low-Dose Direct Oral Anticoagulation vs Dual Antiplatelet Therapy After Left Atrial Appendage Occlusion: The ADALA Randomized Clinical Trial. JAMA Cardiol. Published 1 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it