Arrhythmias & electrophysiology
Anticoagulation Alone vs Anticoagulation Plus Aspirin or DAPT Following Left Atrial Appendage Occlusion
Authors' conclusion
In real-world U.S. practice, discharge on DOAC alone or warfarin alone was associated with a lower rate of adverse events compared with DOAC plus aspirin.
Study context
- Population
- Patients with successful left atrial appendage occlusion (LAAO) with the Watchman FLX (second-generation) device, NCDR LAAO Registry, 2020–2022
- Participants
- 53,878 patients
- Exposure
- Discharge antithrombotic strategies after LAAO vs direct oral anticoagulant (DOAC) plus aspirin
- Outcome
- Adverse events (major adverse events, major bleeding) by discharge antithrombotic strategy
- Follow-up
- 45 days and 6 months
Methodological detailsNCDR LAAO Registry, multivariable Cox proportional hazards regression
- NCDR LAAO Registry
- Multivariable Cox proportional hazards regression
Main finding
As reported in the abstract
Major adverse events and major bleeding · 45 days
DOAC alone vs DOAC plus aspirinHazard ratio (95% CI)
Major adverse events
0.78(0.68–0.91)
Major bleeding
0.69(0.60–0.80)
Observational data: associations, not effects.
Further findings
Major adverse events and major bleeding · 6 months
- Differences (DOAC alone vs DOAC plus aspirin) persisted at 6 months
Major bleeding, warfarin without aspirin · 45 days and 6 months
- Warfarin without aspirin showed lower rates of major bleeding at both time points
Stroke/TIA and device-related thrombus
- No differences in stroke/TIA or device-related thrombus
Original publication
Anticoagulation Alone vs Anticoagulation Plus Aspirin or DAPT Following Left Atrial Appendage Occlusion. J Am Coll Cardiol. Published 3 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it