Early Discontinuation of Antithrombotic Treatment Following Left Atrial Appendage Closure
Section snippets
Methods
From January 2011 to August 2018, a total of 1,094 consecutive patients with nonvalvular AF underwent LAAC closure in 8 centers in Europe and Canada and were included in a registry. Of them, 12 patients were excluded because of procedural death or unsuccessful LAAC leading to 1,082 patients finally being included in the study. Indication, device selection, and post-procedural management were at the discretion of the local team responsible for the patient, according to local recommendations. The
Results
A total of 148 (13.7%) had early complete discontinuation of antithrombotic treatment, at a median time of 90 (Q1 to 3 47 to 100) days after LAAC. Baseline and procedural characteristics according to early antithrombotic treatment discontinuation after LAAC are listed in Table 1. Patients with early antithrombotic treatment discontinuation exhibited a lower CHA2DS2-VASc score, and a lower prevalence of coronary artery and peripheral disease. Early antithrombotic discontinuation patients had a
Discussion
The main results of our study, including a large series of real-world patients with AF who underwent LAAC, can be summarized as follows: (1) ∼15% of patients were not treated with any antiplatelet or anticoagulant agent within 6 months (median 3 months) after LAAC, (2) antithrombotic discontinuation did not translate into an increase in the risk of thromboembolic events after a median follow-up of 2 years, and the rate of ischemic stroke remained much lower than expected, (3) antithrombotic
Disclosures
Dr. Cruz-González is a proctor for Boston Scientific, Abbott, and Lifetech. Dr. Nombela-Franco is a proctor for Abbott. Dr. Rodés-Cabau has received institutional research grants from Boston Scientific. The remaining authors have no conflicts of interest to declare.
Acknowledgment
Dr. Mesnier is supported by a research grant from the Férération Française de Cardiologie (Paris, France). Dr. Rodés-Cabau holds the Research Chair “Fondation Famille Jacques Larivière” for the Development of Structural Heart Disease Interventions.
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