Optimal Antithrombotics After Left Atrial Appendage Closure

James V. Freeman

“The study by Reddy and colleagues has once again demonstrated that DAPT is generally not the preferred antithrombotic therapy after LAAC. These findings are entirely consistent with other large registry and trial results, and hopefully real-world practice patterns will shift accordingly.”

James V. FreemanCardiologist and outcomes researcher, Yale School of Medicine

“Importantly, this finding should be agnostic to device type and can therefore be generalized to other devices besides Watchman FLX Pro. Across the major registry studies and randomized trials to date, the absolute differences in major bleeding between DAPT and full-dose or reduced-dose NOAC monotherapy have been at least 1.5% in the first 2 to 6 months post procedure, which is consistent with the absolute difference of 1.8% at 6 months in this trial. The additional finding of an absolute difference in clinically relevant nonmajor bleeding of 4% to 5% between DAPT and both monotherapies in this study further demonstrates a remarkable opportunity to improve outcomes from LAAC in just the first few months after device implant.”