Key result
LAAC beats placebo and antiplatelets while matching NOACs for preventing stroke or systemic embolism.
Why the study?
Does percutaneous left atrial appendage closure (LAAC) reduce mortality, stroke/systemic embolism, and major bleeding compared with medical treatment in patients with atrial fibrillation?
Meta-Analysis (n=87,831)
Does percutaneous left atrial appendage closure (LAAC) reduce mortality, stroke/systemic embolism, and major bleeding compared with medical treatment in patients with atrial fibrillation?
Effect estimate: HR 1.01 (95% CI 0.53 to 1.92)
p-value: p=0.969
LAAC appears superior to placebo and antiplatelet therapy, and comparable to NOACs, for preventing mortality and stroke/systemic embolism in patients with non-valvular atrial fibrillation.
No takes yet. Share an insight, caveat, or question.
LAAC superior to placebo/antiplatelet and comparable to NOACs for stroke prevention in AF; extends network RCT evidence to mortality benefit.
Sahay et al. (2016) conducted a meta-analysis in atrial fibrillation (n=87,831). Left atrial appendage closure (LAAC) vs. Placebo, antiplatelet therapy (APT), or non-vitamin K antagonist oral anticoagulants (NOAC) was evaluated on stroke/systemic embolism (SE) compared to NOAC (HR 1.01, 95% CI 0.53 to 1.92, p=0.969). Left atrial appendage closure was superior to placebo and antiplatelet therapy, and comparable to NOACs for preventing stroke or systemic embolism (HR vs NOAC 1.01; 95% CI 0.53-1.92; p=0.969).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: