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Left atrial appendage occlusion versus standard medical care in patients with atrial fibrillation and intracerebral haemorrhage : A propensity score-matched follow-up study

Nielsen-Kudsk, Jens Erik; Johnsen, Søren Paaske; Wester, Per; Damgaard, Dorte; Airaksinen, Juhani; Lund, Juha; De Backer, Ole; Pakarinen, Sami; Odenstedt, Jacob and Vikman, Saila, et al. (2017) In EuroIntervention 13(3). p.371-378
Abstract

Aims: The aim of this study was to investigate the prognosis in patients with atrial fibrillation (AF) and intracerebral haemorrhage (ICH) having a left atrial appendage occlusion (LAAO) versus patients receiving standard medical therapy. Methods and results: A total of 151 patients from the Nordic countries with AF and previous ICH who underwent LAAO using the AMPLATZER Cardiac Plug or the AMPLATZER AMULET were compared to a propensity score-matched group of 151 patients receiving standard medical therapy. The two groups were matched so that their risks for stroke and bleeding were similar (CHA2DS2-VASc and HAS-BLED scores). The standard care patients were identified from the Danish Stroke Registry among 787 patients with AF and ICH.... (More)

Aims: The aim of this study was to investigate the prognosis in patients with atrial fibrillation (AF) and intracerebral haemorrhage (ICH) having a left atrial appendage occlusion (LAAO) versus patients receiving standard medical therapy. Methods and results: A total of 151 patients from the Nordic countries with AF and previous ICH who underwent LAAO using the AMPLATZER Cardiac Plug or the AMPLATZER AMULET were compared to a propensity score-matched group of 151 patients receiving standard medical therapy. The two groups were matched so that their risks for stroke and bleeding were similar (CHA2DS2-VASc and HAS-BLED scores). The standard care patients were identified from the Danish Stroke Registry among 787 patients with AF and ICH. The primary endpoint was a composite of all-cause mortality, ischaemic stroke and major bleeding. Patients with AF and a prior ICH treated with LAAO had a lower risk of the composite outcome as compared to patients treated with standard medical care (events/1,000 years [95% confidence interval]: 53.3 [44.3-64.1] vs. 366.7 [298.2-450.9]; hazard ratio 0.16 [0.07-0.37]). Conclusions: LAAO is suggested to be of major clinical benefit in AF patients having sustained an ICH. These results have to be confirmed in a randomised clinical trial.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atrial fibrillation, Clinical research, Left atrial appendage (LAA) closure, Stroke
in
EuroIntervention
volume
13
issue
3
pages
8 pages
publisher
Société Europa Edition
external identifiers
  • scopus:85021176803
ISSN
1774-024X
DOI
10.4244/EIJ-D-17-00201
language
English
LU publication?
no
id
3c0cf7b7-5de1-4466-b00d-cb022f75559e
date added to LUP
2017-08-17 14:50:10
date last changed
2017-08-17 14:50:10
@article{3c0cf7b7-5de1-4466-b00d-cb022f75559e,
  abstract     = {<p>Aims: The aim of this study was to investigate the prognosis in patients with atrial fibrillation (AF) and intracerebral haemorrhage (ICH) having a left atrial appendage occlusion (LAAO) versus patients receiving standard medical therapy. Methods and results: A total of 151 patients from the Nordic countries with AF and previous ICH who underwent LAAO using the AMPLATZER Cardiac Plug or the AMPLATZER AMULET were compared to a propensity score-matched group of 151 patients receiving standard medical therapy. The two groups were matched so that their risks for stroke and bleeding were similar (CHA2DS2-VASc and HAS-BLED scores). The standard care patients were identified from the Danish Stroke Registry among 787 patients with AF and ICH. The primary endpoint was a composite of all-cause mortality, ischaemic stroke and major bleeding. Patients with AF and a prior ICH treated with LAAO had a lower risk of the composite outcome as compared to patients treated with standard medical care (events/1,000 years [95% confidence interval]: 53.3 [44.3-64.1] vs. 366.7 [298.2-450.9]; hazard ratio 0.16 [0.07-0.37]). Conclusions: LAAO is suggested to be of major clinical benefit in AF patients having sustained an ICH. These results have to be confirmed in a randomised clinical trial.</p>},
  author       = {Nielsen-Kudsk, Jens Erik and Johnsen, Søren Paaske and Wester, Per and Damgaard, Dorte and Airaksinen, Juhani and Lund, Juha and De Backer, Ole and Pakarinen, Sami and Odenstedt, Jacob and Vikman, Saila and Settergren, Magnus and Kongstad, Ole and Rosenqvist, Mårten and Krieger, Derk W.},
  issn         = {1774-024X},
  keyword      = {Atrial fibrillation,Clinical research,Left atrial appendage (LAA) closure,Stroke},
  language     = {eng},
  month        = {06},
  number       = {3},
  pages        = {371--378},
  publisher    = {Société Europa Edition},
  series       = {EuroIntervention},
  title        = {Left atrial appendage occlusion versus standard medical care in patients with atrial fibrillation and intracerebral haemorrhage : A propensity score-matched follow-up study},
  url          = {http://dx.doi.org/10.4244/EIJ-D-17-00201},
  volume       = {13},
  year         = {2017},
}