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Impact of the CHA2DS2-VASc score on late clinical outcomes in patients undergoing left atrial appendage occlusion.

Abstract：

BACKGROUND:Left atrial appendage occlusion (LAAO) is an accepted strategy for cardioembolic events prevention in patients with non-valvular atrial fibrillation (AF) unsuitable for anticoagulation. However, uncertainties persist regarding the benefit of LAAO in highly-comorbid patients. The aim of this study was to assess the impact of the CHA2DS2-VASc score beyond thromboembolic risk in predicting clinical outcomes in patients undergoing LAAO. METHODS:160 patients who underwent LAAO were included and categorized into two groups according to their stroke risk (89 with CHA2DS2-VASc >4 vs. 71 with lower risk). The coprimary endpoints were death and stroke at follow-up. Thromboembolic and bleeding events were compared to those predicted from CHA2DS2-VASc and HAS-BLED scores. RESULTS:Over a median follow-up of 679 days, CHA2DS2-VASc >4 was associated with increased all-cause mortality compared with patients with lower thromboembolic risk (HR: 3.23; 95% CI: 1.28-8.19; p < 0.001). However, the rates of stroke after LAAO were not significantly different between risk groups. The observed annual rates of stroke and major bleeding were lower than predicted. CONCLUSIONS:Despite increased long-term mortality in patients with CHA2DS2-VASc >4, LAAO remains beneficial in reducing stroke and bleeding events in high-risk AF patients unsuitable for anticoagulation.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Agudelo V,Millán X,Li CH,Asmarats L,Fernández-Peregrina E,Santaló M,Jimenez-Kockar M,Gheorghe L,Serra A,Arzamendi D

doi

10.1016/j.ijcard.2020.06.054

subject

Has Abstract

pub_date

2020-11-15 00:00:00

pages

78-84

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(20)33432-X

journal_volume

319

pub_type

杂志文章

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