Left atrial appendage occlusion versus standard medical care in patients with atrial fibrillation and intracerebral haemorrhage: a propensity score-matched follow-up study

Left atrial appendage occlusion versus standard medical care in patients with atrial fibrillation and intracerebral haemorrhage : a propensity score-matched follow-up study

Aims: The aim of this study was to investigate the prognosis in patients with atrial fibrillation (AF) and intracerebral haemorrhage (ICH) having a left atrial appendage occlusion (LAAO) versus patients receiving standard medical therapy. Methods and results: A total of 151 patients from the Nordic countries with AF and previous ICH who underwent LAAO using the AMPLATZER Cardiac Plug or the AMPLATZER AMULET were compared to a propensity score-matched group of 151 patients receiving standard medical therapy. The two groups were matched so that their risks for stroke and bleeding were similar (CHA2DS2-VASc and HAS-BLED scores). The standard care patients were identified from the Danish Stroke Registry among 787 patients with AF and ICH. The primary endpoint was a composite of all-cause mortality, ischaemic stroke and major bleeding. Patients with AF and a prior ICH treated with LAAO had a lower risk of the composite outcome as compared to patients treated with standard medical care (events/1,000 years [95% confidence interval]: 53.3 [44.3-64.1] vs. 366.7 [298.2-450.9]; hazard ratio 0.16 [0.07-0.37]). Conclusions: LAAO is suggested to be of major clinical benefit in AF patients having sustained an ICH. These results have to be confirmed in a randomised clinical trial.

Johnsen, Soren Paaske (author)
Wester, PerKarolinska Institutet,Umeå universitet,Medicin,Karolinska Inst, Danderyd, Sweden(Swepub:umu)pewe0002 (author)
Damgaard, Dorte (author)
Airaksinen, Juhani (author)
Lund, Juha (author)
De Backer, Ole (author)
Pakarinen, Sami (author)
Odenstedt, Jacob (author)
Vikman, Saila (author)
Settergren, MagnusKarolinska Institutet (author)
Kongstad, Ole (author)
Rosenqvist, MartenKarolinska Institutet (author)
Krieger, Derk W. (author)
Umeå universitetMedicin (creator_code:org_t)

By the author/editor: Nielsen-Kudsk, J ...; Johnsen, Soren P ...; Wester, Per; Damgaard, Dorte; Airaksinen, Juha ...; Lund, Juha; show more...; De Backer, Ole; Pakarinen, Sami; Odenstedt, Jacob; Vikman, Saila; Settergren, Magn ...; Kongstad, Ole; Rosenqvist, Mart ...; Krieger, Derk W.; show less...

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