Trends in percutaneous left atrial appendage occlusion and 1-year mortality 2013-2021: A nationwide observational study.
Int J Cardiol
; 408: 132098, 2024 Aug 01.
Article
em En
| MEDLINE
| ID: mdl-38679168
ABSTRACT
BACKGROUND:
Percutaneous left atrial appendage occlusion (LAAO) is increasingly used for stroke prevention in patients with atrial fibrillation and anticoagulant-related complications. Yet, real-life studies evaluating changes in patient characteristics and indications for LAAO remain scarce.METHODS:
To evaluate changes in patient characteristics and indications for LAAO defined as 2-year history of intracerebral bleeding, any ischemic stroke/systemic embolism (SE), any non-intracerebral bleeding, other indication, and 1-year mortality. All patients undergoing percutaneous LAAO in Denmark from 2013 to 2021 were stratified into the following year groups 2013-2015, 2016-2018, and 2019-2021.RESULTS:
In total, 1465 patients underwent LAAO. Age remained stable (2013-2015 74 years versus 2019-2021 75 years). Patients' comorbidity burden declined, exemplified by CHA2DS2-VASc ≥4 and HAS-BLED ≥3 decreased from 56.7% and 63.7% in 2013-2015 to 40.3% and 45.8% in 2019-2021. Indications for LAAO changed over time with other indication comprising 44.7% in 2019-2021; up from 26.9% in 2013-2015. Conversely, fewer patients had an indication of any ischemic stroke/SE (2013-2015 30.8% vs 2019-2021 20.3%) or any non-intracerebral bleeding (2013-2015 29.4% vs 2019-2021 23.4%). 1-year mortality was 11.3% for any non-intracerebral bleeding and 6.2% for other indication.CONCLUSION:
The LAAO patient-profile has changed considerably. Age remained stable, while comorbidity burden decreased during the period 2013-2021. LAAO is increasingly used in patients with no clinical event history and mortality differs according to indication. Selection of patients to LAAO should be done carefully, and contemporary real-life studies investigating clinical practice could add important insights.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Apêndice Atrial
Limite:
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2024
Tipo de documento:
Article
País de publicação:
Holanda