Arrhythmias & electrophysiologyCohort study
Early Nonprocedural Bleeding After Left Atrial Appendage Occlusion
- Multicentre cohort study
- 9 centres
Authors' conclusion
Early nonprocedural bleeding after LAAO occurred in ∼7% of patients within 3 months, with more than one-half being classified as major bleeding. Regardless of severity, early nonprocedural bleeding was associated with increased mortality. DAPT at discharge determined an increased risk of early nonprocedural bleeding after LAAO.
Study context
- Population
- Patients undergoing left atrial appendage occlusion (LAAO)
- Participants
- 1,649 patients · 9 centres
- Outcome
- Early nonprocedural bleeding (bleeding unrelated to the procedure; severity by VARC-2)
- Follow-up
- Within 3 months after device implantation
Main finding
As reported in the abstract
Early nonprocedural bleeding
121 (7.3%)
Classified as major bleeding
69 (57.0%); 4.2% of patients
Observational data: associations, not effects.
Further findings
Independent predictors of early nonprocedural bleeding
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| DAPT at discharge | 1.61 (1.12–2.33) | P = 0.01 | |
| Prior gastrointestinal bleeding | 2.15 (1.38–3.35) | P < 0.001 | |
| Multiple locations of prior bleeding | 2.33 (1.34–4.05) | P < 0.001 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
All-cause death associated with early nonprocedural bleeding · median follow-up 2.3 years (Q1-Q3: 1.1-4.1 years)
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| Early nonprocedural bleeding | 1.53 (1.15–2.06) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
Independent predictors of early nonprocedural bleeding
- Dual antiplatelet therapy (DAPT) at discharge predictive of both all and major nonprocedural bleeding at 3 months and 45 days
All-cause death associated with early nonprocedural bleeding · median follow-up 2.3 years (Q1-Q3: 1.1-4.1 years)
- Heightened mortality risk similar at 45 days
Original publication
Summarised from the published abstract; every number is checked against it