Arrhythmias & electrophysiologyMeta-analysis
Network Meta-Analysis of Initial Antithrombotic Regimens After Left Atrial Appendage Occlusion
- Systematic review and network meta-analysis
- frequentist random effects model
- P-score ranking
Authors' conclusion
In this network meta-analysis comparing initial antithrombotic therapies after LAAO, monotherapy with DOAC had the highest likelihood of lower thromboembolic events and major bleeding. DAPT was associated with a lower incidence of thromboembolic events compared with SAPT and may be a preferred option in patients unable to tolerate anticoagulation.
Study context
- Population
- Patients with nonvalvular atrial fibrillation (AF) after left atrial appendage occlusion (LAAO)
- Participants
- 12,451 patients · 41 studies
- Comparison
- Antithrombotic regimens at discharge after LAAO
Pooled result
As reported in the abstract
Device-related thrombosis, all-cause mortality, thromboembolic events and major bleeding
Odds ratio (95% CI)P value
DOAC vs VKAall-cause mortality
0.39(0.17–0.89)
P = 0.03DAPT vs SAPTthromboembolic events
0.50(0.29–0.88)
P = 0.02Safety
Major bleeding
- No difference between dual antiplatelet therapy (DAPT) and single antiplatelet therapy (SAPT)
Original publication
Network Meta-Analysis of Initial Antithrombotic Regimens After Left Atrial Appendage Occlusion. J Am Coll Cardiol. Published 21 August 2023. doi:10.1016/j.jacc.2023.08.010
Summarised from the published abstract; every number is checked against it