Loading...
Clinical Takeaway
: Overall stroke rates were reasonably similar.Context
Left atrial occlusion devices are attractive because they can negate the need for anticoagulation in patients with atrial fibrillation (AF). Six randomized trials have compared left atrial appendage closure (LAAC) with anticoagulation (warfarin in 2 and direct oral anticoagulants [DOACs] in 4); now, a meta-analysis evaluated these trials (7028 patients in total).
Key Results
Overall stroke rates were similar between the two arms (4.0% in LAAC and 3.3% in anticoagulation during 3–5 years of follow-up).
However, ischemic stroke was significantly more common with LAAC (3.4% vs. 2.3%; odds ratio, 1.4).
Not surprisingly, nonprocedural bleeding was lower with LAAC; however, procedure-related bleeding was not analyzed.
Comment
In these patients w…