Short-Term Anticoagulation Therapy After Left Atrial Appendage Occlusion
Document Type
Conference Proceeding
Publication Date
4-1-2025
Publication Title
Journal of the American College of Cardiology
Abstract
Background: Antithrombotic therapy after left atrial appendage occlusion (LAAO) is crucial to prevent device-related thrombosis (DRT). However, large-scale studies comparing warfarin and direct oral anticoagulants (DOACs) for short-term anticoagulation post-LAAO are limited. Methods: Using the TriNetX network, we identified patients (≥18 years old) who underwent LAAO between 2012-2022 and were on warfarin or DOACs for 3 months. Patients were followed up for 1 year after the anticoagulant therapy. The primary outcome was a composite of DRT, ischemic stroke, and major bleeding (intracranial or gastrointestinal). Results: Of the 9,674 patients identified, 8,439 were in the DOAC group and 1,235 in the warfarin group. After propensity score matching and multivariate analysis, the DOAC group had lower odds of the primary composite outcome (aOR: 0.78; 95% CI: 0.64-0.95; p=0.02) than warfarin. They also had lower odds of major bleeding (aOR: 0.60; 95% CI: 0.47-0.76; p< 0.01). No significant differences were seen in DRT (aOR: 1.10; 95% CI: 0.47-2.60; p=0.83), ischemic stroke (aOR: 0.90; 95% CI: 0.69-1.18; p=0.45), or all-cause hospitalization (aOR: 0.97; 95% CI: 0.82-1.16; p=0.76). Subgroup analysis found similar outcomes between apixaban and rivaroxaban. Conclusion: DOACs post-LAAO reduced major bleeding risk with similar DRT and ischemic stroke outcomes compared to warfarin.
Volume
85
Issue
12 Suppl
First Page
264
Last Page
264
Recommended Citation
Yeo YH, Vignarajah A, Wong HKK, Lee JZE, Sorajja D, Russo AM. Short-term anticoagulation therapy after left atrial appendage occlusion. J Am Coll Cardiol. 2025 Apr 1;85(12 Suppl):264. doi:10.1016/S0735-1097(25)00749-1
DOI
10.1016/S0735-1097(25)00749-1
Comments
American College of Cardiology Meeting, March 29-31, 2025, Chicago, IL