Valvular & structural heart diseaseCohort study
Outcomes of Patients With Reduced Left Ventricular Function Undergoing Left Atrial Appendage Occlusion
- Registry study
- National Cardiovascular Data Registry Left Atrial Appendage Occlusion (LAAO) Registry
- adjusted logistic regression and Cox proportional hazards regression
Authors' conclusion
For patients with a reduced LVEF, there was no significant difference in procedural success or major in-hospital complications. There was also no significant difference in stroke through 1 year of follow-up. Patients with a reduced LVEF had higher 1-year mortality, consistent with the known prognosis of patients with heart failure with reduced LVEF. These findings suggest that LAAO is reasonably safe and effective for selected patients with low LVEF, although the net clinical benefit may be attenuated due to the high risk of mortality.
Study context
- Population
- Patients ≥18 years of age with a documented left ventricular ejection fraction (LVEF) who underwent LAAO from December 2015 to December 20235,192 [2.8%] with an LVEF <30%
- Participants
- 186,085 patients
- Exposure
- Outcomes after LAAO stratified according to LVEF
- LVEF <30%n = 5,192
Main finding
As reported in the abstract
P = 0.12
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| In-hospital mortality | adjusted OR 1.39 (95% CI 0.76–2.55) | |
| Any stroke · 1 year | adjusted HR 1.10 (95% CI 0.88–1.37) | |
| Ischemic stroke/arterial thromboembolism · 1 year | adjusted HR 1.26 (95% CI 0.94–1.68) | |
| All-cause mortality · 1 year · highest risk | adjusted HR 1.93 (95% CI 1.75–2.12) | |
| 0.20.5125Ratio (log scale) |
All-cause mortality · 1 year
- All-cause mortality significantly increased for every 10% reduction in LVEF
Original publication
Summarised from the published abstract; every number is checked against it