Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
October 19, 2021Panminerva Medica

Left atrial appendage closure improved primary endpoint-free survival compared to DOACs in nvAF patients with prior cardioembolic events (HR 0.28; 95% CI 0.08-0.97; P=0.044).

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Patients with nvAF who experience a cardioembolic event despite adequate OAC have a high risk of recurrence, requiring further prevention strategies like off-label LAAC.

Does left atrial appendage closure reduce the composite of cardioembolic events, major bleeding, or procedure-related major complications compared to continued DOAC therapy in patients with non-valvular atrial fibrillation who experienced a cardioembolic event despite adequate oral anticoagulation?

Comparison

LAAC vs continued DOAC therapy

Design

Retrospective two-center cohort study with propensity-score matching

Follow-up

Median 3.4 years

Key result

Left atrial appendage closure improved primary endpoint-free survival compared to DOACs in nvAF patients with prior cardioembolic events (HR 0.28; 95% CI 0.08-0.97; P=0.044).

Authors

GFGiulio FalasconiCGCarlo GaspardoneCGCosmo Godino

Discussion

Loading...

Member takes

Overview

Off-label LAAC in OAC-failure nvAF warrants caution; leaves open efficacy questions pending randomized trials.

Study Design

Type

Cohort (n=75)

Multicenter

Yes

Structured PICO

Does left atrial appendage closure reduce the composite of cardioembolic events, major bleeding, or procedure-related major complications compared to continued DOAC therapy in patients with non-valvular atrial fibrillation who experienced a cardioembolic event despite adequate oral anticoagulation?

P
Population
75 patients with non-valvular atrial fibrillation who experienced a cardioembolic event despite adequate oral anticoagulation, followed for a median of 3.4 years.
E
Exposure
Left atrial appendage closure (LAAC) followed by either dual antiplatelet therapy (DAPT) for 3 months then indefinite single antiplatelet therapy, or aspirin plus DOAC for 3 months then indefinite DOAC therapy
C
Comparator
Continued oral anticoagulation therapy with DOACs
O
Outcome
Composite of cardioembolic event, major bleeding, or procedure-related major complicationcomposite

Main Result

Hazard Ratio: 0.28 (95% CI 0.08–0.97)

p-value: p=0.044

Left atrial appendage closure may be a safe and effective strategy to improve event-free survival in patients with non-valvular atrial fibrillation who experience a cardioembolic event despite adequate oral anticoagulation.

Cite This Study

Falasconi et al. (2021) conducted a cohort in Non-valvular atrial fibrillation (nvAF) (n=75). Left atrial appendage closure (LAAC) vs. DOAC therapy was evaluated on Composite of CE event, major bleeding, or procedure-related major complication (HR 0.28, 95% CI 0.08-0.97, p=0.044). Left atrial appendage closure improved primary endpoint-free survival compared to DOACs in nvAF patients with prior cardioembolic events (HR 0.28; 95% CI 0.08-0.97; P=0.044).

synapsesocial.com/papers/6a64a3a7da1d91c0d9c271f8https://doi.org/10.23736/s0031-0808.21.04446-3
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Left atrial appendage closure in patients with cardioembolic stroke despite oral anticoagulant therapy: a multicenter case-control study2025
  2. 2Left Atrial Appendage Closure in Patients with Atrial Fibrillation and Intermediate-to-Borderline High Cardiovascular Risk: A Retrospective Propensity Match Cohort Study2026
  3. 3Left atrial appendage closure in nonvalvular atrial fibrillation patients with percutaneous coronary intervention2022
  4. 4Left atrial appendage closure in nonvalvular atrial fibrillation patients with percutaneous coronary intervention2022 · 1 citations
  5. 5Should left atrial appendage closure be considered in resistant left atrial appendage thrombus cases? ‘Former Foe, New Ally’2024 · 2 citations