Valvular & structural heart diseaseCohort study
Frailty in patients undergoing percutaneous left atrial appendage closure: The Frail-LAAC study
- international, multicenter, prospective study
- consecutive patients
- 4 university centers (2022-2024)
Authors' conclusion
Frailty is common in patients undergoing LAAC and is associated with a 5-fold increased mortality risk. Incorporating frailty assessment into preprocedural evaluations enhanced risk stratification, highlighting the need for careful patient selection, particularly in those with advanced frailty, to optimize outcomes and avoid futile interventions.
Study context
- Population
- Patients undergoing left atrial appendage closure (LAAC)consecutive patients included, frailty in 101 (22.4%)
- Participants
- 452 patients
- Exposure
- frail patients compared to nonfrail patients
- frailn = 101
Main finding
All-cause mortality or ischemic events · median follow-up of 12 (4-22) months
Adjusted hazard ratio
4.85
95% CI 2.85–8.24
P < 0.001
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | frail | nonfrail | prefrail | robust | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|---|---|---|
| Mortality · median follow-up of 12 (4-22) months — frail vs nonfrail | 33.7% | 7.7% | Not reported in the abstract | Not reported in the abstract | 5.28 (2.94–9.46) | P < 0.001 | |
| Mortality · median follow-up of 12 (4-22) months — prefrail vs robust · prefrailty not associated with mortality | 2.87 (0.83–9.98) | P = 0.115 | |||||
| 0.10.31310Adjusted hazard ratio (log scale) |
Device and procedural success
- Device success
- 99.6%
- Procedural success
- 97.3%
Frailty in predictive models
- significantly improved mortality risk stratification
Safety
Procedure-related complications
- no differences across groups
- P = 0.188
Original publication
Summarised from the published abstract; every number is checked against it