Key result
Left atrial appendage closure was associated with a higher risk of ischaemic stroke or systemic embolism (RR 1.41) compared with oral anticoagulation, while concurrently reducing the risk of non-procedural clinically relevant bleeding (RR 0.50).
Why the study?
Does left atrial appendage closure compared to oral anticoagulation reduce stroke or bleeding in patients with atrial fibrillation?
Does left atrial appendage closure compared to oral anticoagulation reduce stroke or bleeding in patients with atrial fibrillation?
Recent meta-analyses indicate that while LAAC reduces non-procedural bleeding compared to oral anticoagulation, it may confer a higher risk of ischemic stroke, highlighting the need for highly personalized clinical decision-making.
This editorial refers to ‘Long-Term Efficacy and Safety of Left Atrial Appendage Closure Versus Oral Anticoagulation in Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials, by P. Karakasis et al. , https://doi.org/10.1093/europace/ euag159 and ‘Comparative Evaluation of Left Atrial Appendage Occlusion And Oral Anticoagulation: A Bayesian Meta-Analysis of Randomized Controlled Trials’, by K. S. Athmakuri et al. , https://doi.org/10.1093/europace/euag163
No takes yet. Share an insight, caveat, or question.
Romiti et al. (2026) conducted an editorial in Atrial fibrillation. Left atrial appendage closure (LAAC) vs. Oral anticoagulation (OAC) was evaluated on Ischaemic stroke or systemic embolism (RR 1.41). Left atrial appendage closure was associated with a higher risk of ischaemic stroke or systemic embolism (RR 1.41) compared with oral anticoagulation, while concurrently reducing the risk of non-procedural clinically relevant bleeding (RR 0.50).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: