Arrhythmias & electrophysiology
Dual Antiplatelet Therapy (DAPT) Is Comparable to Oral Anticoagulation (OAC) Following LAAC With WATCHMAN FLX: A National Registry Analysis
Authors' conclusion
In a large registry, DAPT had a similar safety profile compared with current Food and Drug Administration-approved postimplant drug regimens of OAC with aspirin following LAAO with the Watchman FLX.
Study context
- Population
- Patients undergoing Watchman FLX implantation for AF stroke prevention, NCDR left atrial appendage occlusion (LAAO) registry, August 5, 2020–September 30, 2021mean age 77 y, 40% women
- Participants
- 49,968 patients
- Exposure
- DAPT vs OAC with aspirin after LAAO with Watchman FLX
- DAPTn = 4,155
- DOAC/aspirinn = 24,497reference
- warfarin/aspirinn = 3,913reference
- Outcome
- Composite of:
- Death
- Stroke
- Major bleeding
- Systemic embolism
- Follow-up
- Between discharge and 45 days
Methodological detailspropensity-score matched, 1:1 matching, DAPT patients had more comorbid conditions than OAC/aspirin patients
- Propensity-score matched
- 1:1 matching
- DAPT patients had more comorbid conditions than OAC/aspirin patients
Main finding
As reported in the abstract
Composite endpoint · 45 days
- DAPT vs DOAC/aspirin: P = 0.13
- DAPT vs warfarin/aspirin: P = 0.75
- After propensity score matching (1:1 matched analyses)
Observational data: associations, not effects.
Further findings
Death, stroke, device-related thrombus
- Similar among the groups
Safety
| Outcome | DAPT | DOAC/aspirin | Warfarin/aspirin | P value | |
|---|---|---|---|---|---|
| Major bleeding — DAPT vs DOAC/aspirin · 2.48% vs 3.25%; slightly increased with DOAC/aspirin | P = 0.04 | ||||
| Major bleeding — DAPT vs warfarin/aspirin | 2.25% | Not reported in the abstract | 2.22% | P = 0.93 | DOAC/aspirin: not reported in the abstract |
Original publication
DAPT Is Comparable to OAC Following LAAC With WATCHMAN FLX: A National Registry Analysis. JACC Cardiovasc Interv. Published 8 November 2023. doi:10.
Summarised from the published abstract; every number is checked against it