Effect of Glomerular Filtration Rates on Outcomes Following Percutaneous Left Atrial Appendage Closure
Section snippets
Methods
This was a multicenter study including 1094 patients who underwent percutaneous LAAC in 8 centers. LAAC was performed as previously reported,8 and the approach and device used were left at the discretion of the operators. Patients with failure to implant a device in the left atrial appendage were not included in the present analysis. Most procedures were performed under general anesthesia and trans-esophageal echocardiography (TEE) guidance. After-LAAC management consisted of short term (1 to 3
Results
The main baseline characteristics of the study population are shown in Table 1. The mean patient's age was 75.9±8.4 years, with 38.8% of women. Mean CHA2DS2-VASc and HAS-BLED scores were 4.5±1.5 and 3.6±1.1, respectively. A total of 324 patients (29.6%) had a prior ischemic stroke. Most patients (80.9%) experienced a previous bleeding, of whom 380 (34.7%) had multiple bleeding episodes. A total of 300 patients (27.4%) had an eGFR<45ml/min, including 47 patients with hemodialysis. Patients with
Discussion
Some studies have reported an increased risk of stroke in AF patients with CKD.5,6 Despite the high thrombotic risk observed in CKD patients,11 specific data regarding the efficacy of LAAC in this population were lacking. The present study failed to identify any increase in the thrombotic risk (DRT, ischemic stroke, TIA or peripheral embolism) associated with CKD, and provided reassuring information regarding the efficacy of LAAC in such patients. In fact, the rate of ischemic stroke observed
Disclosures
Dr Laurent Faroux received fellowship support from Institut Servier and the Association Régionale de Cardiologie de Champagne-Ardenne (ARCCA), and research grant from Biotronik, Edwards Lifesciences and Medtronic. Dr. Rodés-Cabau has received institutional research grants from Boston Scientific. Dr. Cruz-Gonzalez is proctor for Abbott, Boston and Lifetech. Dr. Freixa is proctor for Abbott and Lifetech. Dr. Nombela-Franco is proctor for Abbott. Dr. Arzamendi is proctor for Abbott and Boston
Credit Author Statement
Laurent Faroux: Methodology, Formal Analysis, Investigation, Writing – Original Draft; Ignacio Cruz-González: Investigation, Writing – Review & Editing; Dabit Arzamendi: Investigation, Writing – Review & Editing; Xavier Freixa: Investigation, Writing – Review & Editing; Luis Nombela-Franco: Investigation, Writing – Review & Editing; Vicente Peral: Investigation, Writing – Review & Editing; Berenice Caneiro-Queija: Investigation, Writing – Review & Editing; Antonio Mangieri: Investigation,
Declaration of Interests
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this study.
Acknownledgment
Dr. Rodés-Cabau holds the Research Chair “Fondation Famille Jacques Larivière” for the Development of Structural Heart Disease Interventions. Dr. Cruz-González received research grants from the Instituto de Salud Carlos III (PI19/00658) and from the Gerencia Regional de Salud de la Junta de Castilla y León (GRS 3031/A/19).
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