Arrhythmias & electrophysiology
Lower rate of major bleeding in very high risk patients undergoing left atrial appendage occlusion: A propensity score–matched comparison with direct oral anticoagulant
Authors' conclusion
In high-risk patients, LAAO had a similar stroke prevention efficacy but a significantly lower risk of clinically relevant bleeding when compared with DOACs. The clinical benefit of LAAO became significant after 18 months of follow-up.
Study context
- Population
- Patients with AF at very high stroke risk (CHA2DS2-VASc score ≥ 5)matched, of 2381
- Participants
- 554 patients
- Exposure
- Left atrial appendage occlusion (LAAO) vs DOAC
- LAAOn = 277
- DOACn = 277reference
- Outcome
- Composite of:
- CV death
- Thromboembolic (TE) events
- Clinically relevant bleeding
- Follow-up
- During (mean 25 ± 11 months)
Methodological detailsprospective multicentre database
- Prospective multicentre database
Main finding
As reported in the abstract
Composite end point
P = 0.03
Observational data: associations, not effects.
Further findings
TE events (annualized)
P = 0.63
Safety
Clinically relevant bleeding (annualized)
P = 0.04
Original publication
Lower rate of major bleeding in very high risk patients undergoing left atrial appendage occlusion: A propensity score–matched comparison with direct oral anticoagulant. Heart Rhythm. Published 20 January 2024. doi:10.
Summarised from the published abstract; every number is checked against it