Arrhythmias & electrophysiology
Left atrial appendage closure vs oral anticoagulation for stroke prevention in atrial fibrillation: Long-term outcomes from 4 randomized trials
Authors' conclusion
In this meta-analysis of RCTs, LAAC was associated with significantly lower risks of all-cause and cardiovascular death, hemorrhagic stroke, and non-procedural clinically relevant bleeding compared with OACs, without increasing the risk of thromboembolic events or major bleeding.
Study context
- Population
- Patients with atrial fibrillation (AF)
- Participants
- 3,116 patients4 randomized controlled trials (RCTs)
- Comparison
- Left atrial appendage closure (LAAC) vs OAC
- LAACn = 1,736
- OACn = 1,380reference
- Outcome
- Long-term efficacy and safety
- Follow-up
- 36 to 49.6 months
Methodological detailsfixed-effects models
- Fixed-effects models
Pooled result
As reported in the abstract
Efficacy
LAAC vs OACRelative risk (95% CI)
All-cause death
0.78(0.64–0.95)
CV or unexplained death
0.69(0.51–0.94)
Hemorrhagic stroke
0.34(0.16–0.76)
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Non-procedural clinically relevant bleeding | 0.49 (0.40–0.61) | |
| 0.512Relative risk (log scale) |
Major bleeding (procedural and non-procedural)
- Did not differ significantly between groups
Original publication
Left atrial appendage closure vs oral anticoagulation for stroke prevention in atrial fibrillation: Long-term outcomes from 4 randomized trials. Heart Rhythm. Published 5 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →