Arrhythmias & electrophysiologySecondary analysis
Oral Anticoagulation Use and Left Atrial Appendage Occlusion in LAAOS III
- Secondary analysis of the LAAOS III randomised trial
- subgroup analysis by oral anticoagulant (OAC) use
- landmark analyses
- time-dependent covariate model
Authors' conclusion
The benefit of LAA occlusion was consistent whether patients were receiving OACs or not. LAA occlusion provides thromboembolism reduction in patients independent of OAC use.
Study context
- Population
- Patients with AF undergoing cardiac surgery in LAAOS III
- Participants
- 2,887 / 1,401 / 472
- Comparison
- Left atrial appendage (LAA) occlusion vs no occlusion, by OAC use
- OAC at all visitsn = 2,887
- OAC at some visitsn = 1,401
- Never OACn = 472
- Primary endpoint
- Ischemic stroke or systemic embolism, by OAC use
- Follow-up
- After discharge
Primary result
As reported in the abstract
Ischemic stroke or systemic embolism, LAA occlusion vs no occlusion
LAA occlusionHazard ratio (95% CI)
OAC at all visits
0.70(0.51–0.96)
OAC at some visits
0.63(0.43–0.94)
Never OAC
0.76(0.32–1.79)
Further findings
Stroke or systemic embolism, OAC use as time-dependent covariate
- Reduction with LAA occlusion similar whether receiving OACs or not
OAC use at hospital discharge
- VKA
- 3027 (63.5%)
- Direct OAC
- 879 (18.5%)
- No difference in OAC use between treatment arms
Original publication
Oral Anticoagulation Use and Left Atrial Appendage Occlusion in LAAOS III. Circulation. Published 21 September 2023. doi:10.1161/circulationaha.122.060315
Summarised from the published abstract; every number is checked against it