Emerging evidence in Left Atrial Appendage Occlusion vs. Oral anticoagulation therapy with NOAC

Emerging evidence in Left Atrial Appendage Occlusion vs. Oral anticoagulation therapy with NOAC

Propensity Score Matching study with Amulet LAAO subjects presented at 2020 EuroPCR congress

 
 
 

Transcatheter left atrial appendage occlusion (LAAO) is proven non-inferior to warfarin in atrial fibrillation (AF). However, novel oral anticoagulation (NOAC) is now preferred over warfarin as thromboprophylaxis in AF. This study sought to investigate clinical outcome and prognosis in patients with AF treated with either LAAO or NOAC.

Based on the global prospective Amulet Observational Registry (n=1,088), the faculty performed a follow-up study using propensity score 1:2 matching with replacement. A group of 18,570 patients with incident AF and treatment with NOAC (time period 2013-2015) was identified through the Danish National Patient Registry and the Danish National Prescription Registry.

The primary outcome was a composite of ischemic stroke, systemic embolism, major bleeding and all-cause mortality. Secondary outcomes were the individual endpoints of ischemic stroke, major bleeding and all-cause mortality. Both cohorts included the analysis for 2 years of follow-up.

Here, the study author and panelists discuss the findings and wider implications for clinical practice in further detail.

  • Review of study results. What does the latest data tell us?
  • Discussion on study importance and why this information is important?
  • Discussion on clinical insights & impact for future LAAO vs NOAC drug studies
  • Outlook for global CATALYST trial evaluating safety and effectiveness of Amulet compared to NOAC therapy
  • Interventional Cardiologists implanting LAAO devices
  • Electrophysiologists implanting LAAO devices
  • Stroke specialists: Neurologists, General Cardiologists managing high risk ischemic stroke patients
  • Gastroenterologists managing patients who have had or at high risk for bleeding from oral anticoagulant therapy
  • Nephrologists managing patients who have had or at high risk for bleeding from oral anticoagulant therapy

 

Prof Jens Erik Nielsen-Kudsk
Aarhus University, Aarhus, DK

 

Prof John Camm
St George’s University of London, London, UK

 

Dr Vivek Reddy
Mount Sinai Hospital, New York, US

 

 
This webinar is supported by: