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Elsheikh, S, Alobaida, M, Bucci, T, Buckley, B, Gupta, D, Irving, G, Hill, A, Lip, GYH and Abdul-Rahim, AH (2024) Left Atrial Appendage Occlusion Versus Direct Oral Anticoagulants in the Prevention of Ischaemic Stroke in Patients with Atrial Fibrillation. Cerebrovascular Diseases. ISSN 1015-9770
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Left Atrial Appendage Occlusion Versus Direct Oral Anticoagulants in the Prevention of Ischaemic Stroke in Patients with Atrial Fibrillation.pdf - Accepted Version Download (284kB) | Preview |
Abstract
Introduction Existing randomised controlled trials assessing the safety and efficacy of left atrial appendage occlusion (LAAO) in atrial fibrillation (AF) were of relatively small sample size, or included patients who could receive oral anticoagulant treatment after device implantation. We compared the outcomes of patients with newly diagnosed AF who received percutaneous LAAO or direct oral anticoagulants (DOAC) treatment, in a large population from a global federated health network (TriNetX). Methods Patients with AF treated with percutaneous LAAO were matched with those treated with DOAC between 1st December 2010 and 1st October 2018. Outcomes were all-cause mortality, ischaemic stroke and intracranial haemorrhage (ICH) at 5 years. Results We included 200 patients with AF, who received either LAAO or DOAC. The risk of all-cause mortality, ischaemic stroke and ICH at 5 years was not significantly different between the two groups (Risk Ratio [RR] for all-cause mortality: 1.52, 95% confidence interval (CI): 0.97- 2.38, RR for ischaemic stroke: 1.09, 95% CI: 0.51- 2.36, and RR for ICH: 1.0, 95% CI: 0.44- 2.30). Conclusion Patients newly diagnosed with AF, eligible for DOAC, showed similar 5-year risk of death, ischemic stroke, and ICH when comparing those who underwent percutaneous LAAO to those receiving DOAC. Future randomised controlled trials are needed to confirm the findings and advise changes in guidelines.
| Item Type: | Article |
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| Uncontrolled Keywords: | 1103 Clinical Sciences; 1109 Neurosciences; Neurology & Neurosurgery |
| Subjects: | R Medicine > RC Internal medicine > RC1200 Sports Medicine R Medicine > RT Nursing |
| Divisions: | Nursing & Allied Health Sport & Exercise Sciences |
| Publisher: | Karger Publishers |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 29 Jan 2024 09:54 |
| Last Modified: | 13 Mar 2024 16:00 |
| DOI or ID number: | 10.1159/000536546 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/22454 |
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