Causes of death and morbidity in patients with atrial fibrillation after left atrial appendage occlusion
| Autor: | Wojciech Ogorzeja, Radosław Litwinowicz, Marian Burysz, Aleksandra Burysz, Krzysztof Bartuś |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Hemorrhage 030204 cardiovascular system & hematology Malignancy Left atrial appendage occlusion 03 medical and health sciences 0302 clinical medicine Cause of Death Thromboembolism Internal medicine Atrial Fibrillation medicine Humans Atrial Appendage In patient Heart Atria Adverse effect Stroke Aged Retrospective Studies Aged 80 and over Aspirin business.industry Mortality rate Atrial fibrillation Middle Aged medicine.disease Cardiology Female Poland Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Kardiologia Polska. 77:1047-1054 |
| ISSN: | 1897-4279 0022-9032 |
| Popis: | Background: Left atrial appendage occlusion (LAAO) is a safe and effective alternative for stroke prevention in patients with atrial fibrillation (AF). However, there is little literature on the exact causes of death and adverse events during follow‑up after LAAO. Aims: The primary aim of this study was to evaluate survival free of any serious adverse events and of any‑cause death in midterm follow‑up. The secondary aims were to analyze causes of mortality and further hospitalization as well as adverse events, thromboembolism, and bleeding risk reduction during follow‑up. Methods: A retrospective, single‑center study was performed in 84 consecutive patients with AF who underwent LAAO with endocardial occluders. The mean (SD) CHADS2 score was 3.5 (1.1), CHA2DS2‑VASc score, 5.0 (1.5), and HAS‑BLED score, 4.4 (0.9). After LAAO, dual 6‑month antiplatelet therapy and then lifelong aspirin monotherapy was recommended. Mean (SD) follow‑up was 25.3 (13.2) months with an accumulated total follow‑up of 174.6 patient‑years. Results: The annual mortality rate was 12.02%. More than half of deaths (57%) were due to noncardiovascular causes with leading malignancy. Survival at the end of the periprocedural period was 98.8%, at 3 months, 97.6%, at 6 months, 95.2%, at 12 months, 86.5%, at 18 months, 85.1%, and at 24 months, 80.6%. The average annual thromboembolic event rate was 2.87%. The most common adverse event was severe bleeding with an annual rate of 6.3% (3 cases while receiving dual antiplatelet therapy and 6 cases while receiving aspirin). Conclusions: The majority of deaths were not related to stroke in patients with AF after LAAO. Mortality in first 2 years following the procedure was predominantly from noncardiovascular causes. |
| Databáze: | OpenAIRE |
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