1. Residual stroke risk after left atrial appendage closure in patients with prior oral anticoagulation failure
- Author
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Radosław, Pracoń, Kamil, Zieliński, Sripal, Bangalore, Marek, Konka, Mariusz, Kruk, Cezary, Kępka, Piotr, Trochimiuk, Mariusz, Dębski, Jakub, Przyłuski, Edyta, Kaczmarska, Zofia, Dzielińska, Andrzej, Kurowski, Adam, Witkowski, and Marcin, Demkow
- Subjects
Stroke ,Treatment Outcome ,Ischemic Attack, Transient ,Atrial Fibrillation ,Anticoagulants ,Humans ,Atrial Appendage ,Hemorrhage ,Thrombosis ,Cardiology and Cardiovascular Medicine - Abstract
Patients with atrial fibrillation (AF) and oral anticoagulation (OAC) failure may benefit from left atrial appendage closure (LAAC), however, the evidence is scarce. We report outcomes of LAAC in patients with OAC failure compared to those with classic indications of OAC contraindications.Prospective registry of LAAC with Amplatzer or WATCHMAN device followed by dual antiplatelet therapy (DAPT) was analyzed (05.2014-11.2019). The study group included patients with OAC failure defined as stroke/TIA/PE/LAA thrombus (n = 39) during OAC, whereas the control group consisted of patients with OAC contraindications (n = 156). Structured follow-up at 3, 6, and 12 months was done.The study group compared to controls was younger [73 (IQR, 62-77) vs 74 (IQR, 68-81) years, P = 0.046], with higher CHAPatients after LAAC for OAC failure and unremarkable prior bleeding history presented with high residual stroke and low bleeding risks. Therefore concomitant long-term OAC or prolonged DAPT should strongly be considered in this population.
- Published
- 2022