1-Year Clinical Outcomes and the Impact of Procedural Configurations in Left Atrial Appendage Occlusion Patients

作者：Chao Gao, Fangju Su, Jianzheng Liu, Tingting Zhang, Zhongping Ning, Bing Yang, Huimin Chu, Ben He, Junfeng Zhang, Ling Zhou, Yuechun Li, Yushun Zhang, Hao Hu, Yawei Xu, Jie Zeng, Jun Guo, Xi Su, Zhongbao Ruan, Haitao Liu, Ping Wang, Scot Garg, Osama Soliman, David R. Holmes, Patrick W. Serruys, Ling Tao · 发表于：JACC Asia · 年份：2024 · DOI：10.1016/j.jacasi.2024.07.013 · 被引用次数：6 · 研究领域：Atrial Fibrillation Management and Outcomes、Cardiovascular Disease and Adiposity、Cardiac Arrhythmias and Treatments

Background: The clinical performance of left atrial appendage occlusion (LAAO) as a procedure and the long-term impact of its varied implantation configurations and anticoagulation regimens remain unclear. Objectives: This study sought to provide data in routine practice from a prospective multicenter registry. Methods: A total of 3,096 consecutive patients from 39 Chinese centers undergoing LAAO were enrolled between April 1, 2019, and October 31, 2020. Results: -VASc and HAS-BLED scores were 4.0 ± 1.8 and 2.4 ± 1.2, respectively; mean age was 69 ± 9 years. One-year follow-up was completed in 3,013 (97.8%) patients. The ischemic endpoint of death, stroke, and systemic embolism occurred in 133 (4.51%) patients, and life-threatening, disabling, or major bleeding occurred in 71 (2.36%) patients. After inverse probability of treatment weighting, no significant association was found between anesthesia type (moderate sedation vs general anesthesia) or image guidance (transesophageal/intracardiac echocardiography vs fluoroscopy) and ischemic or bleeding events. In 1,295 (42.0%) cases, LAAO combined with catheter ablation was associated with a significantly lower rate of death, stroke, or systemic embolism than LAAO only (3.5% vs 5.2%, inverse probability of treatment weighting HR: 0.68; 95% CI: 0.47-0.99). The most common post-LAAO antithrombotic regimen was warfarin/direct oral anticoagulant monotherapy for 45 days, followed by single-/dual-antiplatelet therapy (38.1%). Conclusion...