Key result
LAAO in AF patients with cancer shows similar ischemic stroke rates versus those without cancer.
Why the study?
The prevention of stroke in patients with atrial fibrillation and cancer is challenging due to increased bleeding and thrombotic risk, and the safety and efficacy of left atrial appendage occlusion in this population needed assessment.
Does left atrial appendage occlusion (LAAO) reduce stroke without increasing bleeding risk in patients with nonvalvular atrial fibrillation and cancer compared to those without cancer?
Cohort (n=55)
Yes
Does left atrial appendage occlusion (LAAO) reduce stroke without increasing bleeding risk in patients with nonvalvular atrial fibrillation and cancer compared to those without cancer?
Hazard Ratio: 0.44 (95% CI 0.1–1.97)
p-value: p=0.28
Left atrial appendage occlusion in patients with atrial fibrillation and cancer appears to offer a reduction in stroke with no increased bleeding risk compared to patients without cancer.
LAAO may be feasible in cancer patients with AF; leaves open need for randomized trials to confirm stroke reduction and bleeding safety.
The prevention of stroke in patients with atrial fibrillation (AF) and cancer is challenging because patients are at increased bleeding and thrombotic risk. The authors sought to assess left atrial appendage occlusion (LAAO) as a safe and effective strategy for reducing stroke at no increased bleeding risk in cancer patients with AF. We reviewed patients with nonvalvular AF who underwent LAAO at Mayo Clinic sites from 2017 to 2020 and identified those who had undergone prior or current treatment for cancer. We compared the incidence of stroke, bleeding, device complications, and death with a control group who underwent LAAO without malignancy. Fifty-five patients were included; 44 (80.0%) were male, and the mean age was 79.0 ± 6.1 years. The median CHA2Ds2-VASc score was 5 (Q1-Q3: 4-6), with 47 (85.5%) having a prior bleeding event. Over the first year, ischemic stroke occurred in 1 (1.4%) patient, bleeding complications in 5 (10.7%) patients, and death in 3 (6.5%) patients. Compared with controls who underwent LAAO without cancer, there was no significant difference in ischemic stroke (HR: 0.44; 95% CI: 0.10-1.97; P = 0.28), bleeding complication (HR: 0.71; 95% CI: 0.28-1.86; P = 0.19), or death (HR: 1.39; 95% CI: 0.73-2.64; P = 0.32). Within our cohort, LAAO in cancer patients was achieved with good procedural success and offered a reduction in stroke at no increased bleeding risk similar to noncancer patients.
No takes yet. Share an insight, caveat, or question.
Shabtaie et al. (2023) conducted a cohort in Atrial fibrillation and cancer (n=55). Left atrial appendage occlusion (LAAO) with concurrent cancer vs. LAAO without cancer was evaluated on Ischemic stroke (HR 0.44, 95% CI 0.10-1.97, p=0.28). Left atrial appendage occlusion in patients with atrial fibrillation and cancer was associated with similar rates of ischemic stroke compared to patients without cancer (HR 0.44; 95% CI 0.10-1.97; P=0.28).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: