The following is a summary of “Clinical Outcomes of Left Atrial Appendage Occlusion Versus Switch of Direct Oral Anticoagulants in Atrial Fibrillation: A Territory‐Wide Retrospective Analysis,” published in the October 2023 issue of Cardiology by Kei-Yan et al.
The study aimed to compare outcomes between left atrial appendage occlusion (LAAO) and a switch from one direct oral anticoagulant (DOAC) to another in atrial fibrillation patients. A total of 2,350 patients (874 LAAO, 1,476 DOAC switch) were included.
Over a mean follow-up of 1052±694 days, the primary outcome (a composite of all-cause mortality, ischemic stroke, and major bleeding) occurred in 24.6% in the LAAO group and 22.7% in the DOAC switch group (hazard ratio [HR], 0.94 [95% CI, 0.80–1.12]; P=0.516). The LAAO group showed lower all-cause and cardiovascular mortality rates but similar rates of ischemic stroke compared to the DOAC switch group. Overall major bleeding risk was similar between the groups but was lower in the LAAO group after six months.
LAAO and DOAC switch presented comparable risks for the composite outcome, while LAAO showed lower risks of all-cause and cardiovascular mortality compared to the DOAC switch.
Source: ahajournals.org/doi/10.1161/JAHA.123.029421
