Seeking the Optimal Antithrombotic Therapy After Left Atrial Appendage Occlusion

Left atrial appendage occlusion (LAAO) is a procedure performed most commonly in patients with atrial fibrillation, who have a high risk for subsequent bleeding from full-intensity anticoagulation. After successful LAAO, most patients still receive some form of antithrombotic therapy, but there is no clear consensus on the optimal regimen. In a multicenter, open-label, randomized trial, researchers compared the effect of two strategies: low-intensity direct oral anticoagulation with apixaban 2.5 mg twice daily and clopidogrel-based dual antiplatelet therapy.

The primary outcome was a composite of a safety event — major bleeding according to the Bleeding Academic Research Consortium definition — and several efficacy events — ischemic stroke, …