Impact of the CHA2DS2-VASc score on late clinical outcomes in patients undergoing left atrial appendage occlusion.
Int J Cardiol
; 319: 78-84, 2020 Nov 15.
Article
em En
| MEDLINE
| ID: mdl-32634500
ABSTRACT
BACKGROUND:
Left atrial appendage occlusion (LAAO) is an accepted strategy for cardioembolic events prevention in patients with non-valvular atrial fibrillation (AF) unsuitable for anticoagulation. However, uncertainties persist regarding the benefit of LAAO in highly-comorbid patients. The aim of this study was to assess the impact of the CHA2DS2-VASc score beyond thromboembolic risk in predicting clinical outcomes in patients undergoing LAAO.METHODS:
160 patients who underwent LAAO were included and categorized into two groups according to their stroke risk (89 with CHA2DS2-VASc >4 vs. 71 with lower risk). The coprimary endpoints were death and stroke at follow-up. Thromboembolic and bleeding events were compared to those predicted from CHA2DS2-VASc and HAS-BLED scores.RESULTS:
Over a median follow-up of 679 days, CHA2DS2-VASc >4 was associated with increased all-cause mortality compared with patients with lower thromboembolic risk (HR 3.23; 95% CI 1.28-8.19; p < 0.001). However, the rates of stroke after LAAO were not significantly different between risk groups. The observed annual rates of stroke and major bleeding were lower than predicted.CONCLUSIONS:
Despite increased long-term mortality in patients with CHA2DS2-VASc >4, LAAO remains beneficial in reducing stroke and bleeding events in high-risk AF patients unsuitable for anticoagulation.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Apêndice Atrial
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2020
Tipo de documento:
Article