Reduction in risk of stroke and bleeding after left atrial appendage closure with LARIAT device in patients with increased risk of stroke and bleeding: Long term results.
BACKGROUNDS
Left atrial appendage occlusion (LAAO) offers an alternative to oral anticoagulation (OAC) for patients with atrial fibrillation (AF). The aim of this study was to present long-term clinical outcomes of LAAO in patients with a high risk of stroke and thromboembolic events (CHA2 DS2 -VAS-score ≥ 2) and bleeding (HAS-BLED score ≥ 2).


MATERIAL AND METHODS
A prospective, single-center study was performed in 120 patients who were screened for LAAO with the LARIAT. Out of these 89 patients were underwent LARIAT placement, were 57 had high risk of thromboembolic and bleeding risk (LAA group). Control Group consisted of patients and 31 who screened out from the LARIAT and did not undergo LAAO.


RESULTS
The mean CHA2 DS2 -VAS-score was 3.6 ± 1.5 versus 3.1 ± 1.2 and HAS-BLED score was 3.6 ± 1 versus 3 ± 1 compare LAA group versus control group. There were no thromboembolic events in the LAA group. In the control group thromboembolic events were observed in 9.6% (P = 0.017). Annual mortality rate was 1.8% in LAA group and 3.2% in control group (P < 0.05). Estimated bleeding risk reduction in LAA group was 62.2%.


CONCLUSIONS
Long-term data confirmed that left atrial appendage closure with the LARIAT device is an effective and safe treatment in nonvalvular AF patients with high risk of stroke and bleeding.
['Litwinowicz|Radoslaw|R|https://orcid.org/0000-0003-3736-8987', 'Bartus|Magdalena|M|', 'Kapelak|Boguslaw|B|', 'Suwalski|Piotr|P|', 'Lakkireddy|Dhanunjaya|D|https://orcid.org/0000-0002-1492-2693', 'Lee|Randall J|RJ|', 'Bartus|Krzysztof|K|']
D000368:Aged D000925:Anticoagulants D020517:Atrial Appendage D001281:Atrial Fibrillation D006328:Cardiac Catheterization D004867:Equipment Design D005260:Female D006470:Hemorrhage D006801:Humans D015994:Incidence D008297:Male D008875:Middle Aged D011446:Prospective Studies D012042:Registries D018570:Risk Assessment D012307:Risk Factors D020521:Stroke D013923:Thromboembolism D013997:Time Factors D016896:Treatment Outcome
stroke bleeding anticoagulants/antithrombins vascular complications