Arrhythmias & electrophysiologyRandomised controlled trial
Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing Device Thrombosis Following Left Atrial Appendage Closure: The ANDES Randomized Clinical Trial
- Randomised controlled trial
- multicentre
- international
- prospective
- blinded central echocardiography laboratory
Authors' conclusion
The use of DOACs after LAAC failed to reduce DRT compared with DAPT, but it was associated with an improved safety profile.
Study context
- Population
- Patients with nonvalvular AF undergoing transcatheter left atrial appendage closure (LAAC)399 per-protocol
- Participants
- 510 patients
- Comparison
- DOAC vs dual antiplatelet therapy (DAPT) for 60 days after LAAC
- DOACn = 253
- DAPTn = 257reference
- Primary endpoint
- Device-related thrombosis (DRT) on transesophageal echocardiography, per-protocol
- Follow-up
- 60 days after LAAC
Primary result
DRT · 60 days
Difference
−2.7%
95% CI −6.0% to 0.6%
P = 0.110
Events by treatment group
DOAC vs DAPT
difference −2.7% (95% CI −6.0% to 0.6%); P = 0.110
As reported in the abstract
Safety
| Outcome | DOAC | DAPT | difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Safety outcome (all-cause mortality, stroke, bleeding or site-reported DRT) · within 60 days · intention-to-treat analysis | 22.5% | 34.9% | −12.4% (−20.6% to −4.2%) | P = 0.003 | |
| Bleeding events · within 60 days | 17.4% | 24.9% | −7.5% (−14.6% to −0.4%) | P = 0.038 | |
| −30−20−10010Difference (linear scale) |
Original publication
Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing Device Thrombosis Following Left Atrial Appendage Closure: The ANDES Randomized Clinical Trial. Circulation. Published 26 October 2025. doi:10.1161/circulationaha.125.077469
Summarised from the published abstract; every number is checked against it