B-43 | Outcomes of Left Atrial Appendage Closure With Watchman Among Patients in CKD and ESRD

CKD and ESRD are significant causes of mortality and morbidity. Left atrial appendage closure (LAAC) with Watchman device is an alternative strategy to oral anticoagulation for decreasing ischemic stroke risk in selected patients with atrial fibrillation (AF) Outcomes after Watchman device placement in patients with CKD and ESRD have conflicting results. We queried National Inpatient Sample of the years 2016 to 2020. We identified patients who were admitted for a Watchman procedure using ICD10-PCS codes. The risk of mortality and in-hospital complications in the CKD/ESRD group was compared to the non-CKD/ESRD group using multivariate logistic regression analysis. During 2016-2020, there were a total of 90,060 patients who underwent Watchman device placement in the US of which 13200(14.7%) had either CKD or ESRD while the remaining 76860(85.3%) had neither CKD nor ESRD. The mean age was 75.5y in CKD/ESRD group vs 76 y in non-CKD/ESRD group. 4945(37.5%%) were female in CKD/ESRD group vs 32639 females (42.5%) in non- CKD/ESRD group. After adjusting for demographics, there were lower odds of stroke in patients with CKD/ESRD after Watchman device placement compared to non-CKD/ESRD group (aOR (adjusted odds ratio) 0.73; 95% CI 0.58–0.93 p=0.011). There were no differences in odds of in- hospital mortality, GI bleed, sepsis, Length of stay (LOS), and mean total cost of care between 2 groups (Table 1) Watchman device placement in CKD/ESRD has lower odds of stroke compared to non-CKD/ESRD group. Further observational studies and RCTs are needed to elucidate it.