Key result
In patients with nonvalvular atrial fibrillation undergoing left atrial appendage closure, those with prior percutaneous coronary intervention had similar rates of stroke or transient ischemic attack compared to those without.
Why the study?
Antithrombotic therapy for nonvalvular atrial fibrillation patients with percutaneous coronary intervention remains contradictory and challenging, prompting assessment of left atrial appendage closure.
Does left atrial appendage closure (LAAC) safely prevent thromboembolic and bleeding events in nonvalvular atrial fibrillation patients with prior percutaneous coronary intervention compared to those without?
Cohort (n=109)
Yes
Does left atrial appendage closure (LAAC) safely prevent thromboembolic and bleeding events in nonvalvular atrial fibrillation patients with prior percutaneous coronary intervention compared to those without?
Answers are grounded in this paper and cite their sources.
LAAC is a safe and effective option for stroke prevention in NVAF patients with a history of PCI, demonstrating comparable long-term outcomes to those without PCI.
OBJECTIVES: Nonvalvular atrial fibrillation (NVAF) concomitant with coronary artery disease (CAD) may increase the risk of thromboembolism. Antithrombotic therapy for NVAF patients with percutaneous coronary intervention (PCI) remains contradictory and challenging. This study aimed to assess the safety and efficacy of left atrial appendage closure (LAAC) in a cohort of patients with NVAF and PCI. METHODS: A total of 109 patients undergoing LAAC procedures between March 2017 and December 2020 were categorized into 2 groups, Group I included 36 patients with PCI while group II included 73 patients without. Peri-procedural and long-term complications, as well as ischemia and bleeding events, were retrospectively analyzed. RESULTS: Group I had more diabetes mellitus (55.6% vs. 26.0%; p = 0.003), higher CHA2DS2-VASc scores (5.44 ± 1.85 vs. 4.22 ± 1.64; p = 0.002) and HAS-BLED scores (3.39 ± 0.93 vs. 2.74 ± 1.05; p = 0.003) compared to Group II. Procedure-related complications within 7 days were similar in both groups (8.3% vs. 8.2%; P = 1.000). Over a median follow-up period of 20.9 months, there were no significant differences between two subgroups with regard to cardiovascular death (2.8% vs. 0%, p = 0.330), stroke/transient ischemic attack (2.8% vs. 5.5%, p = 1.000), major bleeding (0% vs. 2.7%, p = 1.000) and device-related thrombus (8.3% vs. 1.4%, p = 0.104). The observed annualized thromboembolic and major bleeding events determined by Kaplan-Meier analysis decreased by 82.4% and 100% in group I, 55.9% and 75.8% in group II, respectively. CONCLUSION: LAAC is a safe and effective option for stroke prevention in NVAF patients with PCI.
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Yu et al. (2022) conducted a cohort in Nonvalvular atrial fibrillation (n=109). Prior percutaneous coronary intervention vs. No prior percutaneous coronary intervention was evaluated on Stroke/transient ischemic attack (p=1.000). In patients with nonvalvular atrial fibrillation undergoing left atrial appendage closure, those with prior percutaneous coronary intervention had similar rates of stroke or transient ischemic attack compared to those without.
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