Why the study?
Patients with nonvalvular atrial fibrillation who experience acute ischemic stroke despite oral anticoagulation have a high risk of recurrence even after changing anticoagulants, leaving the role of left atrial appendage closure unclear.
Does endovascular LAAC prevent recurrent acute ischemic stroke in NVAF patients who had AIS despite regular OAC use?
Comparison
Endovascular LAAC for recurrent stroke prevention
Design
Single hospital system retrospective review
Follow-up
Mean of 1.75±1.0 years
Key result
Left atrial appendage closure in patients with atrial fibrillation and acute ischemic stroke despite anticoagulation demonstrated a low annual rate of recurrent stroke (1.97 per 100 patient-years).
Authors
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LAAC was associated with low recurrent stroke rates in this cohort; leaves open need for randomized trials before practice change.
Cohort (n=29)
No
Does endovascular LAAC prevent recurrent acute ischemic stroke in NVAF patients who had AIS despite regular OAC use?
Absolute Event Rate: 1.97% vs 8.44%
LAAC demonstrated a low annual rate of recurrent AIS (1.97%) in NVAF patients with prior AIS despite OAC, suggesting a potential role for LAAC in this high-risk population.
Fouks et al. (2023) conducted a cohort in Nonvalvular atrial fibrillation with acute ischemic stroke despite oral anticoagulation (n=29). Endovascular left atrial appendage closure (LAAC) vs. Expected incidence rate based on CHA2DS2-VASc scores was evaluated on Occurrence of acute ischemic stroke (AIS) after LAAC. Left atrial appendage closure in patients with atrial fibrillation and acute ischemic stroke despite anticoagulation demonstrated a low annual rate of recurrent stroke (1.97 per 100 patient-years).
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