Ding, Wern Yew 
ORCID: 0000-0003-3596-6545, Rivera-Caravaca, Jose Miguel ORCID: 0000-0003-0492-6241, Fazio-Eynullayeva, Elnara, Underhill, Paula, Gupta, Dhiraj, Marin, Francisco and Lip, Gregory YH ORCID: 0000-0002-7566-1626
(2022)
Outcomes of left atrial appendage occlusion vs. non-vitamin K antagonist oral anticoagulants in atrial fibrillation.
CLINICAL RESEARCH IN CARDIOLOGY, 111 (9).
pp. 1040-1047.
Abstract
<h4>Background</h4>The effects of left atrial appendage (LAA) occlusion compared to non-vitamin K antagonist oral anticoagulant (NOAC) therapy in patients with atrial fibrillation (AF) remain unknown.<h4>Aims</h4>We aimed to evaluate the outcomes in patients with AF who received LAA occlusion vs. NOAC therapy.<h4>Methods</h4>We utilised data from TriNetX which is a global federated health research network currently containing data for 88.5 million patients. ICD-10 codes were employed to identify AF patients treated with either LAA occlusion or NOAC between 1st December 2010 and 17th January 2019. Clinical outcomes of interest were analysed up to 2 years.<h4>Results</h4>108,697 patients were included. Patients who underwent LAA occlusion were younger, more likely to be white Caucasian and male, had a greater incidence of comorbidities, and were less likely to be prescribed other cardiovascular medications. Using propensity score matching, the risk of all-cause mortality was significantly lower among patients who received LAA occlusion compared to NOAC therapy [1.51% vs. 5.60%, RR 0.27 (95% CI 0.14-0.54)], but there were no statistical differences in the composite thrombotic or thromboembolic events [8.17% vs. 7.72%, RR 1.06 (95% CI 0.73-1.53)], ischaemic stroke or TIA [4.69% vs. 5.45%, RR 0.86 (95% CI 0.54-1.38)], venous thromboembolism [1.66% vs. 1.51%, RR 1.10 (95% CI 0.47-2.57)] and intracranial haemorrhage [1.51% vs. 1.51%, RR 1.00 (95% CI 0.42-2.39)].<h4>Conclusion</h4>Overall, LAA occlusion might be a suitable alternative to NOAC therapy for stroke prevention in patients with AF.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Atrial fibrillation, Left atrial appendage occlusion, Non-vitamin K antagonist oral anticoagulant, Outcome, All-cause mortality, Thromboembolism |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Faculty Management Office Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 24 Jan 2022 10:52 |
| Last Modified: | 18 Jan 2023 21:14 |
| DOI: | 10.1007/s00392-021-01983-z |
| Open Access URL: | https://doi.org/10.1007/s00392-021-01983-z |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3147539 |
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