Key result
LAmbre occluder shows comparable major efficacy outcomes to Amplatzer devices in left atrial appendage closure.
Why the study?
The long-term clinical outcomes of the novel LAmbre occluder compared to established Amplatzer devices for left atrial appendage closure in atrial fibrillation patients were not well characterized.
Cohort (n=265)
No
Hazard Ratio: 0.73 (95% CI 0.38–1.4)
Absolute Event Rate: 8.2% vs 10.5%
p-value: p=.34
Supports LAmbre consideration for LAA closure; extends real-world comparisons but leaves open randomized confirmation.
INTRODUCTION: The LAmbre (LifeTech Scientific, Shenzhen, China) is a novel occluder for left atrial appendage closure (LAAC) in patients with atrial fibrillation. This study compares late clinical outcomes of LAmbre and the established Amplatzer devices (Abbott, St Paul, MN). METHODS: Between 2012 and 2018, 265 consecutive patients underwent LAAC with LAmbre and Amplatzer devices at a single center. After a 3:1 propensity score matching, 40 (LAmbre) vs 107 (Amplatzer) patients were compared by the primary efficacy endpoint of all-cause stroke, systemic embolism and cardiovascular/unexplained death, the primary safety endpoint of major periprocedural complications and major bleeding events at follow-up, and the combined hazard endpoint, a composite of all the above-mentioned hazards. RESULTS: -VASc score 4.8 ± 1.7 vs 4.8 ± 1.7 and HAS-BLED score 3.1 ± 0.9 vs 3.2 ± 0.8 were similar. After 3.6 ± 1.9 vs 2.5 ± 1.4 years, the clinical efficacy (12/146, 8.2% [LAmbre] vs 28/266, 10.5% [Amplatzer]; hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.38-1.40; P = .34) and safety (5/146, 3.4% vs 14/266, 5.3%; HR, 0.47; 95% CI, 0.14-1.6; P = .22), as well as the combined hazard endpoint (15/146, 10.3% vs 36/266, 13.6%; HR, 0.67; 95% CI, 0.36-1.25; P = .21) were comparable. CONCLUSION: In the presented report, in patients with nonvalvular atrial fibrillation, the LAmbre offered similar long-term efficacy and safety in comparison to Amplatzer devices.
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Schnupp et al. (2020) conducted a cohort in Atrial fibrillation (n=265). LAmbre occluder vs. Amplatzer occluder was evaluated on Composite of all-cause stroke, systemic embolism, and cardiovascular/unexplained death (HR 0.73, 95% CI 0.38-1.40, p=.34). The LAmbre occluder was associated with a comparable primary efficacy rate (HR 0.73) compared to Amplatzer devices for left atrial appendage closure in patients with nonvalvular atrial fibrillation.
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