Outcomes of left atrial appendage closure versus oral anticoagulant therapy in patients with atrial fibrillation: an updated meta-analysis of randomized control trials

Abstract

Abstract Background The purpose of this study is to compare the clinical results of Left Atrial Appendage Closure (LAAC) and oral anticoagulation (OAC) in individuals with AF. Methods For randomized controlled trials (RCTs) comparing the clinical results of OAC to LAAC in patients with atrial fibrillation (AF), we searched PubMed, ScienceDirect, and Cochrane. The included publications were subjected to meta-analyses using Review Manager v5.4. Results In comparison to OAC, LAAC was linked with a decreased incidence of all stroke (OR 0.68; 95% CI 0.55–0.84; p = 0.0004). LAAC was also linked to a decreased risk of hemorrhagic stroke (OR 0.20, 95% CI 0.07–0.55; p = 0.002). There is no statistically significant difference between the two groups in terms of ischemic stroke (OR 1.05; 95% CI 0.59–1.84; p = 0.88) or systemic embolization (OR 1.02; 95% CI 0.42–2.46; p = 0.97). Conclusions According to our meta-analysis, the LAAC was less likely than the OAC to have a complete or hemorrhagic stroke. For the two groups, however, there was no difference in the risk of ischemic stroke or systemic embolization.

Keywords

• Atrial fibrillation
• Left atrial appendage closure
• Oral anticoagulant