Evidence map›Paper›PMID 26318322›Full record

Observational studyClinical research in cardiology : official journal of the German Cardiac Society2016

Efficacy and safety of percutaneous left atrial appendage closure to prevent thromboembolic events in atrial fibrillation patients with high stroke and bleeding risk.

Julia Seeger, Carlo Bothner, Tillman Dahme, Birgid Gonska, Dominik Scharnbeck, Sinisa Markovic, Wolfgang Rottbauer, Jochen Wöhrle

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Clinical research in cardiology : official journal of the German Cardiac Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 3 pooled it
2.1field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 21 citations in OpenAlex.

  1. Risk factors, clinical implications, and management of peridevice leak following left atrial appendage closure: A systematic review.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Review
  6. Article
  7. Review
  8. Observational
  9. Article
  10. Value of the CHAClinical research in cardiology : official journal of the German Cardiac Society · 2018
    Article
  11. Review
  12. Percutaneous closure of an incomplete left atrial appendage closure.Clinical research in cardiology : official journal of the German Cardiac Society · 2016
    Article
  13. Percutaneous management of periprocedural cardiac perforation during left atrial appendage closure.Clinical research in cardiology : official journal of the German Cardiac Society · 2016
    Article
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Julia SeegerDepartment of Internal Medicine II, Cardiology, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Carlo BothnerDepartment of Internal Medicine II, Cardiology, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Tillman DahmeDepartment of Internal Medicine II, Cardiology, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Birgid GonskaDepartment of Internal Medicine II, Cardiology, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Dominik ScharnbeckDepartment of Internal Medicine II, Cardiology, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Sinisa MarkovicDepartment of Internal Medicine II, Cardiology, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Wolfgang RottbauerDepartment of Internal Medicine II, Cardiology, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
Jochen WöhrleDepartment of Internal Medicine II, Cardiology, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. jochen.woehrle@uniklinik-ulm.de.
Universität Ulm · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe randomized PROTECT AF trial demonstrated non-inferiority of left atrial appendage (LAA) closure to oral anticoagulation with warfarin. Current guidelines give a class IIb recommendation for LAA closure. We evaluated the efficacy and safety of LAA closure in a consecutive series of non-valvular atrial fibrillation patients with contraindications to long-term oral anticoagulation or at high bleeding risk. METHODS AND

results101 consecutive non-valvular atrial fibrillation patients (age 74.7 ± 7.5 years) at high risk for stroke (CHA2DS2-VASc Score 4.4 ± 1.6) and high bleeding risk (HAS-BLED Score 4.2 ± 1.3) received LAA closure with either the Watchman closure device (n = 38) or the Amplatzer cardiac plug (n = 63). Dual antiplatelet therapy with aspirin and clopidogrel was recommended for 3-6 months after device implantation, followed by long-term antiplatelet therapy with aspirin. No anticoagulation was given after device implantation. Mean follow-up was 400 days. One patient (1 %) experienced a transient ischemic attack, and two patients (2 %) suffered from ischemic stroke. While on recommended antiplatelet therapy, bleeding occurred in 12/101 patients (12 %). Bleeding was significantly reduced with 3 compared with 6 months dual antiplatelet therapy (3.0 vs. 16.2 %, p < 0.05) while ischemic or thrombotic events were similar.

conclusionLeft atrial appendage closure in patients with non-valvular atrial fibrillation and high risk for stroke and bleeding events effectively prevented stroke and reduced cerebral ischemic events compared to expected stroke rate according to CHA2DS2-VASc Score. Dual antiplatelet therapy for 3 months reduced the rate of bleeding events compared to 6 months therapy with no increase of thrombotic events.

Indexed as

AnticoagulantsAtrial AppendageAdministration, OralAgedAged, 80 and overAtrial FibrillationCardiac CatheterizationContraindicationsDrug Therapy, CombinationEquipment DesignFemaleHemorrhageHumansIschemic Attack, TransientMaleMiddle AgedAnticoagulantsPlatelet Aggregation InhibitorsBleeding eventLeft atrial appendageRisk factorsTranscatheter closure

Identifiers

PMID26318322
OpenAlexW1861011579

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.