Modified post-LAAC antithrombotic regimens without dual antiplatelet therapy resulted in 0% device-related thrombosis compared to 13% with the standard regimen, with no difference in major bleeding.
Observational (n=74)
No
Does a modified reduced-dose antithrombotic regimen after LAAC prevent device-related thrombosis and major bleeding compared to standard regimens in patients with high bleeding risk?
Absolute Event Rate: 0% vs 13%
p-value: p=0.0257
BACKGROUND: Antithrombotic therapy after left atrial appendage closure (LAAC) in patients at high risk of bleeding remains controversial. We present real-world clinical outcomes of LAAC. METHODS AND RESULTS: Data from 74 consecutive patients who received LAAC therapy between January 2020 and June 2022 were analyzed. Patients received 1 of 3 antithrombotic therapies according to the bleeding risk category or clinical event. Regimen 1 was based on a prior study, regimen 2 comprised a lower antiplatelet drug dose without dual antiplatelet therapy, and regimen 3 was antiplatelet drug administration for as long as possible to patients with uncontrollable bleeding who were required to stop anticoagulant drugs. Overall, 73 (98.6%) procedures were successful. Of them, 16 (21.9%) patients were selected for regimen 1, 46 (63.0%) for regimen 2, and 11 (15.1%) for regimen 3. Device-related thrombosis (13% vs. 0% vs. 0%, P=0.0257) only occurred with regimen 1. There was no difference in major bleeding event rates (6% vs. 2% vs. 9%, P=0.53). CONCLUSIONS: The post-LAAC antithrombotic regimen was modified without major concerns.
Ryuzaki et al. (Mon,) conducted a observational in Nonvalvular atrial fibrillation with high bleeding risk (n=74). Modified antithrombotic regimens (Regimen 2 and 3) vs. Standard IFU-listed regimen (Regimen 1) was evaluated on Device-related thrombosis (p=0.0257). Modified post-LAAC antithrombotic regimens without dual antiplatelet therapy resulted in 0% device-related thrombosis compared to 13% with the standard regimen, with no difference in major bleeding.