Arrhythmias & electrophysiology
Reduced direct oral anticoagulant dose vs dual antiplatelet therapy after left atrial appendage closure in patients with nonvalvular atrial fibrillation: A systematic review and meta-analysis
Pooled result · Device-related thrombusResult — go to the resultRelative risk 0.37 95% CI 0.15–0.94Authors' conclusion
In this systematic review and meta-analysis, the use of l-DOACs in patients with nonvalvular atrial fibrillation who underwent LAAC reduces the occurrence of the DRT and composite outcomes of thromboembolic events and major bleeding.
Study context
- Population
- Patients with nonvalvular AF after left atrial appendage closure
- Participants
- 1,015 patients · 2 RCTs · 3 nonrandomised cohorts
- Comparison
- Low-dose DOAC vs dual antiplatelet therapy (DAPT) after left atrial appendage closure (LAAC)
- Outcome
- Device-related thrombus (DRT)
Methodological detailsrandom effects model
- Random effects model
Pooled result
Device-related thrombus
Relative risk
0.37
95% CI 0.15–0.94
P = 0.04
By group
l-DOAC vs DAPT
RR 0.37 (95% CI 0.15–0.94); P = 0.04
As reported in the abstract
Further pooled results
| Outcome | l-DOAC | DAPT | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Composite of thromboembolic events and major bleedingI2 = 0% | 1.41% | 11.13% | 0.14 (0.05–0.36) | P < 0.0001 | |
| 0.050.21520Relative risk (log scale) |
Original publication
Reduced direct oral anticoagulant dose vs dual antiplatelet therapy after left atrial appendage closure in patients with nonvalvular atrial fibrillation: A systematic review and meta-analysis. Heart Rhythm. Published 22 November 2024. doi:10.
Summarised from the published abstract; every number is checked against it