Comparison in Patients < 75 Years of Age - Versus – Those > 75 Years on One-year-Events With Atrial Fibrillation and Left Atrial Appendage Occluder (From the Prospective Multicenter German LAARGE Registry)

Nasasra AE, Brachmann J, Lewalter T, Akin I, Sievert H, Nienaber CA, Weiß C, Pleger ST, Ince H, Maier J, Achenbach S, Sigusch HH, Hochadel M, Schneider S, Senges J, Zeymer U (2020)

Publication Type: Journal article

Publication year: 2020

Journal

American Journal of Cardiology Elsevier

DOI: 10.1016/j.amjcard.2020.09.017

Abstract

Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation therapy in patients with non-valvular atrial fibrillation for the prevention of embolic stroke and systemic embolism. Although elderly patients (>75 years) have both higher ischemic and bleeding risk as compared with younger patients, they benefit from optimal anticoagulation. The subanalysis aimed to assess the indications, the safety, efficacy, and 1-year outcomes of interventional LAAC in elderly patients (≥ 75 years) compared with younger (< 75 years) patients in clinical practice. We analyzed data from the prospective Left-Atrium-Appendage Occluder Registry Germany. A total of 638 patients were included in the registry, 402 (63%) were aged ≥ 75 years. Compared with younger subjects, patients aged ≥75 were more likely to have higher CHA2DS2-VASC and HAS-BLED scores. Procedural success rate was high und similar in both groups (97.6%). Periprocedural adverse events were not statistically significant in groups (11.9% in <75 years vs 12.9% in ≥75 years; p = 0.80). At 1 year follow-up, all-cause mortality was higher in patients aged ≥75 compared withwith younger group (13.0% vs 7.8 %,p = 0.04), mainly due to non-cardiovascular causes (10.6% vs 6.0%). No significant differences in major bleeding, stroke, systemic embolism were observed. In conclusion, LAAC is feasible and safe in patients with AF at high stroke risk and with contraindications for OAC and should be considered as candidates for LAA closure. Elderly patients often present these characteristics and could benefit from this novel therapy.

Authors with CRIS profile

Stephan Achenbach Lehrstuhl für Innere Medizin II

Involved external institutions

Ruprecht-Karls-Universität Heidelberg DE Germany (DE) SLK-Kliniken Heilbronn GmbH DE Germany (DE) Anglia Ruskin University GB United Kingdom (GB) Klinikum der Stadt Ludwigshafen am Rhein gGmbH DE Germany (DE) Universitätsklinikum Mannheim DE Germany (DE) Klinikum Coburg DE Germany (DE) Städtisches Klinikum Lüneburg DE Germany (DE) Universität Rostock DE Germany (DE) IHF GmbH Institut für Herzinfarktforschung DE Germany (DE) Heinrich-Braun-Klinikum (HBK) DE Germany (DE) München Klinik gGmbH DE Germany (DE) Royal Brompton Hospital GB United Kingdom (GB)

How to cite

APA:

Nasasra, A.E., Brachmann, J., Lewalter, T., Akin, I., Sievert, H., Nienaber, C.A.,... Zeymer, U. (2020). Comparison in Patients < 75 Years of Age - Versus – Those > 75 Years on One-year-Events With Atrial Fibrillation and Left Atrial Appendage Occluder (From the Prospective Multicenter German LAARGE Registry). American Journal of Cardiology. https://doi.org/10.1016/j.amjcard.2020.09.017

MLA:

Nasasra, Aref El, et al. "Comparison in Patients < 75 Years of Age - Versus – Those > 75 Years on One-year-Events With Atrial Fibrillation and Left Atrial Appendage Occluder (From the Prospective Multicenter German LAARGE Registry)." American Journal of Cardiology (2020).

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