Abstract
Abstract 11747: Meta-Analysis on Left Atrial Appendage Closure for Atrial Fibrillation During Cardiac Surgery
Circulation (New York, N.Y.), Vol.144(Suppl_1), pp.A11747-A11747
11/16/2021
DOI: 10.1161/circ.144.suppl_1.11747
Abstract
IntroductionThe current guidelines indicate that left atrial appendage (LAA) excision or exclusion during cardiac surgery has a class IIA recommendation for atrial fibrillation. However, the short- and long-term side effects are not well reported or defined. Methods/ResultsWe conducted a meta-analysis of all studies that compared LAA exclusion during cardiac surgery in patients with AF compared to a placebo arm. Five randomized controlled trials (RCTs) and 23 observational studies were included with a total of 540,111 patients. In regards to postoperative stroke/embolic events, the LAA exclusion group had a significantly decreased risk (risk ratio [RR] 0.75; 95% confidence interval [CI] 0.64 to 0.87; p=0.0002, I2=0%). This significantly reduced risk of stroke/embolic events for the LAAC arm was also seen in both the perioperative period (RR 0.82, 95% CI 0.69 to 0.96, p=0.01, I2=41%) and when follow-up was greater than two years (RR 0.70, 95% CI 0.57 to 0.85, p=0.0003, I2=39%). In terms of all-cause mortality, there was no significant difference for the LAA exclusion group in the early perioperative period (RR 0.84, 95% CI 0.56 to 1.28, p=0.42, I2=85%); however, it was significant after a follow-up of greater than two years (RR 0.81, 95% CI 0.68 to 0.97, p=0.02, I2=79%). ConclusionThis meta-analysis illustrates a significantly decreased risk of postoperative stroke/embolic events in the perioperative period and after a follow-up period greater than two years. Although the early postoperative all-cause mortality did not show a significant difference between the two groups, there was a significant decreased risk in the LAA excision group after a follow-up duration of two years.
Details
- Title: Subtitle
- Abstract 11747: Meta-Analysis on Left Atrial Appendage Closure for Atrial Fibrillation During Cardiac Surgery
- Creators
- Rohan M Prasad - Michigan State UniversityYehia Saleh - Houston MethodistAbdullah Al-abcha - Michigan State UniversityMohammad Fahad F Salam - Michigan State UniversityOla Abdelkarim - Alexandria University
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.144(Suppl_1), pp.A11747-A11747
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1161/circ.144.suppl_1.11747
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/16/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984757273602771
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