Impact of Left Atrial Appendage Closure During Cardiac Surgery on the Occurrence of Early Postoperative Atrial Fibrillation, Stroke, and Mortality: A Propensity Score-Matched Analysis of 10 633 Patients
Authors' conclusion
After adjustment for treatment allocation bias, LAA closure during routine cardiac surgery was significantly associated with an increased risk of early POAF, but it did not influence the risk of stroke or mortality.
Study context
- Population
- Adults undergoing CABG and valve surgery, January 2000–December 2005
- Participants
- 9,792 adults · 461 matched pairs
- Exposure
- Left atrial appendage (LAA) closure vs no LAA closure during cardiac surgery
- LAA closuren = 461
- No LAA closuren = 461reference
- Outcome
- Early postoperative AF (AF ≤30 days of surgery), ischemic stroke and mortality
Methodological detailspropensity-score matched
- Propensity-score matched
Main finding
As reported in the abstract
Early POAF · ≤30 days of surgery
LAA closure vs No LAA closureEstimate (95% CI)P value
Early POAF; P refers to the rate comparison
adjusted OR 3.88(2.89–5.20)
P < 0.001Stroke
adjusted HR 1.07(0.72–1.58)
Mortality
adjusted HR 0.92(0.75–1.13)
- Overall incidence of postoperative atrial fibrillation (POAF) in matched cohort
- 53.9%
Observational data: associations, not effects.
Original publication
Impact of Left Atrial Appendage Closure During Cardiac Surgery on the Occurrence of Early Postoperative Atrial Fibrillation, Stroke, and Mortality: A Propensity Score-Matched Analysis of 10 633 Patients. Circulation. Published 30 November 2016. doi:10.
Summarised from the published abstract; every number is checked against it