1. Systematic review and meta-analysis of left atrial appendage closure's influence on early and long-term mortality and strokeCentral MessagePerspective
- Author
-
Mariusz Kowalewski, MD, PhD, Michał Święczkowski, MD, Łukasz Kuźma, MD, PhD, Bart Maesen, MD, PhD, Emil Julian Dąbrowski, MD, Matteo Matteucci, MD, Jakub Batko, MD, PhD, Radosław Litwinowicz, MD, PhD, Adam Kowalówka, MD, PhD, Wojciech Wańha, MD, PhD, Federica Jiritano, MD, PhD, Giuseppe Maria Raffa, MD, PhD, Pietro Giorgio Malvindi, MD, PhD, Luigi Pannone, MD, Paolo Meani, MD, PhD, Roberto Lorusso, MD, PhD, Richard Whitlock, MD, PhD, Mark La Meir, MD, PhD, Carlo de Asmundis, MD, PhD, James Cox, MD, PhD, and Piotr Suwalski, MD, PhD
- Subjects
atrial fibrillation ,left atrial appendage closure ,heart surgery ,arrhythmia ,systematic review ,meta-analysis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Surgery ,RD1-811 - Abstract
Objective: Left atrial appendage closure (LAAC) concomitant to heart surgery in patients with underlying atrial fibrillation (AF) has gained attention because of long-term reduction of thromboembolic complications. As of mortality benefits in the setting of non-AF, data from both observational studies and randomized controlled trials are conflicting. Methods: On-line databases were screened for studies comparing LAAC versus no LAAC concomitant to other heart surgery. End points assessed were all-cause mortality and stroke at early and longest-available follow-up. Subgroup analyses stratified on preoperative AF were performed. Risk ratios (RR) with 95% CIs served as primary statistics. Results: Electronic search yielded 25 studies (N = 660 [158 patients]). There was no difference between LAAC and no LAAC in terms of early mortality. In the overall population analysis, LAAC reduced long-term mortality (RR, 0.86; 95% CI, 0.74-1.00; P = .05; I2 = 88%), reduced early stroke risk by 19% (RR, 0.81; 95% CI, 0.72-0.93; P = .002; I2 = 57%), and reduced late stroke risk by 13% (RR, 0.87; 95% CI, 0.84-0.90; P
- Published
- 2024
- Full Text
- View/download PDF