Arrhythmias & electrophysiologyMeta-analysis
Long-term efficacy and safety of left atrial appendage closure vs. oral anticoagulation in atrial fibrillation: a meta-analysis of randomized controlled trials
- Systematic review and meta-analysis of randomised controlled trials
- random-effects models
- GRADE certainty of evidence
Authors' conclusion
In patients with AF, LAAC results in a higher risk of ischaemic stroke or systemic embolism than an OAC-based strategy. Compared with OAC, LAAC has no effect on major bleeding or mortality and does not reduce haemorrhagic stroke.
Study context
- Population
- Patients with atrial fibrillation (AF)
- Participants
- 7,004 patients · 6 randomized controlled trials (RCTs)
- Comparison
- Left atrial appendage closure (LAAC) vs oral anticoagulation (OAC)
- LAACn = 3,681
- OACn = 3,323reference
Pooled result
Ischaemic stroke or systemic embolism
Relative risk
1.41
95% CI 1.07–1.86
Events by group
LAAC
134
events
OAC
80
events
LAAC vs OAC
RR 1.41 (95% CI 1.07–1.86)
As reported in the abstract
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Nonprocedural clinically relevant bleeding · high CoE; reduced with LAAC | 0.50 (0.43–0.59) | |
| 0.512Relative risk (log scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Long-term efficacy and safety of left atrial appendage closure vs. oral anticoagulation in atrial fibrillation: a meta-analysis of randomized controlled trials. Europace. Published 23 July 2026. doi:10.1093/europace/euag159
Summarised from the published abstract; every number is checked against it