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Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation - PubMed

4 hours ago
  • #Atrial Fibrillation
  • #Left Atrial Appendage Closure
  • #Stroke Prevention
  • Study compares left atrial appendage closure (LAAC) with physician-directed best medical care for stroke prevention in atrial fibrillation patients at high risk for stroke and bleeding.
  • Multicenter randomized trial in Germany with 912 patients (mean age 77.9 years, 38.6% women).
  • Primary endpoint: composite of stroke, systemic embolism, major bleeding, or cardiovascular/unexplained death.
  • LAAC did not meet noninferiority criteria compared to medical therapy (hazard ratio margin 1.3).
  • Incidence of primary endpoint events: 16.8 per 100 patient-years (LAAC) vs. 13.3 (medical therapy).
  • Serious adverse events occurred in 82.5% of LAAC patients and 77.4% of medical therapy patients.
  • Conclusion: LAAC was not noninferior to medical therapy for high-risk atrial fibrillation patients.