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Favorable neurological outcome after ischemic cerebrovascular events in patients treated with percutaneous left atrial appendage occlusion compared with warfarin

  • 주제(키워드) anticoagulants , atrial fibrillation , left atrial appendage occlusion , stroke
  • 주제(기타) Cardiac & Cardiovascular Systems
  • 설명문(일반) [Lee, Oh-Hyun] Yonsei Univ, Coll Med, Yongin Severance Hosp, Div Cardiol, Seoul, Gyeonggi Do, South Korea; [Kim, Young Dae; Heo, Ji Hoe] Yonsei Univ, Coll Med, Dept Neurol, Seoul, South Korea; [Kim, Jung-Sun; Pak, Hui-Nam; Hong, Geu-Ru; Shim, Chi Young; Uhm, Jae-Sun; Cho, In-Jeong; Joung, Boyoung; Hong, Sung-Jin; Ahn, Chul-Min; Kim, Byeong-Keuk; Ko, Young-Guk; Choi, Donghoon; Hong, Myeong-Ki; Jang, Yangsoo] Yonsei Univ, Coll Med, Severance Cardiovasc Hosp, Div Cardiol, 03722 Yonsei Ro 50-1, Seoul, South Korea; [Yu, Cheol-Woong; Lim, Do-Sun] Korea Univ, Anam Hosp, Seoul, South Korea; [Lee, Hyun-Jong; Choi, Rak-kyeong] Sejong Gen Hosp, Seoul, South Korea; [Kang, Woong-Chol] Gachon Univ, Gil Hosp, Incheon, South Korea; [Shin, Eun-Seok] Univ Ulsan, Ulsan Univ Hosp, Coll Med, Ulsan, South Korea; [Freixa, Xavier] Univ Barcelona, Hosp Clin Barcelona, Barcelona, Spain; [Tzikas, Apostolos] AHEPA Univ Hosp, Thessaloniki, Greece; [Heo, Ji Hoe] Coburg Hosp, Dept Cardiol, Coburg, Germany
  • 등재 SCIE, SCOPUS
  • 발행기관 WILEY
  • 발행년도 2019
  • 총서유형 Journal
  • URI http://www.dcollection.net/handler/ewha/000000171999
  • 본문언어 영어
  • Published As https://dx.doi.org/10.1002/ccd.27913

초록/요약

Objectives This study sought to investigate neurological disability after ischemic cerebrovascular events in patients treated with left atrial appendage (LAA) occlusion compared with those on warfarin. Background Prior studies demonstrated that cerebrovascular events after LAA occlusion in patients with nonvalvular atrial fibrillation (NVAF) is largely nondisabling. Methods From the 1,189 patients in the Korean LAA Occlusion and European Amplatzer Cardiac Plug Multi-Center Registry, 24 patients who experienced ischemic cerebrovascular events after LAA occlusion were enrolled. The neurological outcomes were compared with those in 68 patients who experienced an ischemic cerebrovascular event while on warfarin (Yonsei Stroke Registry). A modified Rankin scale (mRS) score of 3-6 categorized the cerebrovascular event as disabling. The mRS at discharge and at 3 and 12 months postcerebrovascular event in the two groups was compared. Results The percentages of disabling cerebrovascular events were 37.5% and 58.8% at discharge (P = 0.07), 20.8% and 42.6% at 3 months (P = 0.08), and 12.5% and 39.7% at 12 months (P = 0.02) in the LAA occlusion and warfarin groups, respectively. The mRS was significantly lower in the LAA occlusion group at discharge and at 3 months (P < 0.01) and 12 months (P < 0.01) postcerebrovascular event despite no significant difference in mRS before cerebrovascular events (P = 0.98). Patients in the LAA occlusion group demonstrated a significant reduction in mRS between discharge and 12 months (P < 0.01), unlike patients in the warfarin group (P = 0.10). Conclusions Ischemic cerebrovascular events in patients who previously underwent percutaneous LAA occlusion for NVAF were more favorable than in patients on warfarin.

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