Why the study?
There is currently limited evidence about patients with high thromboembolic risk undergoing left atrial appendage closure compared to remaining patients.
Does left atrial appendage closure have similar safety and survival outcomes in atrial fibrillation patients with high thromboembolic risk compared to lower risk patients?
Population
549 consecutive patients undergoing LAAC across 9 centres
Comparison
CHA2DS2-VA score > 4 vs remaining patients
Design
Retrospective multicentre registry analysis
Follow-up
5-year
Key result
In AF patients undergoing LAAC, high thromboembolic risk was associated with similar major short-term complications (5.7% vs 4.0%, p=0.417) but reduced 5-year survival (73.1% vs 83.5%, p=0.002).
Authors
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High-risk patients face reduced survival warranting closer monitoring; leaves open whether targeted interventions improve outcomes in trials.
Cohort (n=549)
Yes
Does left atrial appendage closure have similar safety and survival outcomes in atrial fibrillation patients with high thromboembolic risk compared to lower risk patients?
Absolute Event Rate: 5.7% vs 4%
p-value: p=0.417
LAAC in atrial fibrillation patients with high thromboembolic risk has similar periprocedural safety to lower-risk patients, though long-term survival is worse, likely reflecting their higher baseline comorbidity burden.
Zweiker et al. (2026) conducted a cohort in Atrial fibrillation (n=549). High thromboembolic risk (CHA2DS2-VA score > 4) vs. Remaining patients (CHA2DS2-VA score ≤ 4) was evaluated on Major short-term complications (any complication necessitating an invasive intervention, or death) (p=0.417). In AF patients undergoing LAAC, high thromboembolic risk was associated with similar major short-term complications (5.7% vs 4.0%, p=0.417) but reduced 5-year survival (73.1% vs 83.5%, p=0.002).
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