Comparison of Efficacy and Safety of Left Atrial Appendage Occlusion in Patients Aged <75 to ≥75 Years

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• 作者：Xavier Freixa ; MD^a ; ^{xavierfreixa@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Sameer Gafoor ; MD^b ; ^c ; Ander Regueiro ; MD^a ; Ignacio Cruz-Gonzalez ; MD ; PhD^d ; Samera Shakir ; MD^e ; Heyder Omran ; MD^f ; Sergio Berti ; MD^g ; Gennaro Santoro ; MD^h ; Joelle Kefer ; MD ; PhDⁱ ; Ulf Landmesser ; MD ; PhD^j ; Jens Erik Nielsen-Kudsk ; MD ; DMSc^k ; Horst Sievert ; MD^b ; Prapa Kanagaratnam ; MD ; PhD^l ; Fabian Nietlispach ; MD ; PhD^m ; Steffen Gloekler ; MD^e ; Adel Aminian ; MDⁿ ; Paolo Danna ; MD ; PhD^o ; Marco Rezzaghi^g ; Friederike Stock ; MD^f ; Miroslava Stolcova ; MD^h ; Marco Costa ; MD ; PhD^p ; Reda Ibrahim ; MD^q ; Wolfgang Schillinger ; MD^r ; Jai-Wun Park ; MD ; PhD^s ; Bernhard Meier ; MD^e ; Apostolos Tzikas ; MD ; PhD^t
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：1 January 2016
• 年：2016
• 卷：117
• 期：1
• 页码：84-90
• 全文大小：1132 K

文摘

Left atrial appendage occlusion (LAAO) is emerging as a promising alternative to oral anticoagulation. Because aged patients present a greater risk of not only cardioembolic events but also major bleeding, LAAO might represent a valid alternative as this would allow oral anticoagulation cessation while keeping cardioembolic protection. The objective of the study was to explore the safety and efficacy of LAAO in elderly patients. Data from the AMPLATZER Cardiac Plug multicenter registry were analyzed. The cohort was categorized in 2 groups (<75 vs ≥75 years). A total of 1,053 subjects were included in the registry. Of them, 219 were excluded because of combined procedures. As a result, 828 subjects were included (54.6% ≥75 years). Procedural success was high and similar in both groups (97.3%). Acute procedural major adverse events were not statistically different among groups (3.2% in <75 years vs 5.1%; p = 0.17) although stratified analysis showed a higher incidence of cardiac tamponade in elderly patients (0.5% vs 2.2%; p = 0.04). With a median follow-up of 16.8 months, no significant differences in stroke/TIA (1.9% vs 2.3%; p = 0.89) and major bleeding (1.7% vs 2.6%; p = 0.54) were observed. In conclusion, LAAO was associated with similar procedural success in patients aged <75 and ≥75 years although older patients had a higher incidence of cardiac tamponade. At follow-up, stroke and major bleeding rates were similar among groups.