1. Two-year clinical outcome from the Iberian registry patients after left atrial appendage closure
- Author
-
Victoria Martin Yuste, Amparo Benedicto Buendía, Javier Elduayen Gragera, Juan Manuel Nogales Asensio, Jesús Herrero Garibi, José Ramón López Mínguez, Antonio J. Domínguez-Franco, Federico Gimeno de Carlos, Jose Antonio Fernandez Diaz, Vasco Gama Ribeiro, Felipe Hernández, Marco Costa, Ignacio Cruz González, and Raúl Moreno González
- Subjects
Male ,medicine.medical_specialty ,Gastrointestinal Diseases ,Septal Occluder Device ,Hemorrhage ,Prosthesis Design ,Prosthesis Implantation ,Thromboembolism ,Diabetes mellitus ,Internal medicine ,Atrial Fibrillation ,Occlusion ,medicine ,Humans ,Atrial Appendage ,Heart Atria ,Registries ,Stroke ,Aged ,Aspirin ,business.industry ,Vascular disease ,Atrial fibrillation ,medicine.disease ,Clopidogrel ,Surgery ,Fibrilhação Auricular ,Treatment Outcome ,Heart failure ,Apêndice Auricular ,Oclusão Terapêutica ,Cardiology ,Female ,Therapeutic Occlusion ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
AIMS: The aim of this study was to observe the percentage of thromboembolic and haemorrhagic events over a 2-year follow-up in patients with non-valvular atrial fibrillation (NVAF) undergoing closure of the left atrial appendage (LAA) with an occlusion device. Observed events and CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke history), CHA2DS2-VASc (also adding: vascular disease and sex) and HAS-BLED (hypertension, abnormal liver/renal function, stroke history, bleeding predisposition, labile international normalised ratios, elderly, drugs/alcohol use)-predicted events were compared. METHODS: LAA closure with an occlusion device was performed in 167 NVAF patients contraindicated for oral anticoagulants and recruited from 12 hospitals between 2009 and 2013. At least two transoesophageal echocardiograms were performed in the first 6 months postimplantation. Antithrombotics included clopidogrel and aspirin. Patients were monitored for death, stroke, major and relevant bleeding and hospitalisation for concomitant conditions. Mean age was 74.68±8.58, median follow-up was 24 months, 5.38% had intraoperative complications and implantation was successful in 94.6% of subjects. Mortality during follow-up was 10.8%, mostly (9.5%) non-cardiac related. Bleeding occurred in 10.1% of subjects, 5.7% major and 4.4% minor though relevant, and 4.4% suffered stroke. Major bleeding and stroke/transient ischaemic attack events within 2 years (annual event rates, 290 patients/year) were less frequent than expected from CHADS2 (2.4% vs 9.6%), CHA2DS2-VASc (2.4% vs 8.3%) and HAS-BLED (3.1% vs 6.6%) risk scores (p
- Published
- 2015
- Full Text
- View/download PDF