ArticleJournal of nephrology2021
Outcomes on safety and efficacy of left atrial appendage occlusion in end stage renal disease patients undergoing dialysis.
Article in Journal of nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 24 papers, 5 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
24 citing papers in PubMed, 5 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Transcatheter left atrial appendage occlusion in patients with chronic kidney disease: a systematic review and meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Pooled it
- 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- Efficacy and safety of patients with chronic kidney disease undergoing left atrial appendage closure for atrial fibrillation.PloS one · 2023Pooled it
- The use of non-vitamin K oral anticoagulants in dialysis patients-A systematic review.Seminars in dialysis · 2022Pooled it
- A double paradox: end-stage renal disease-high thromboembolic and bleeding risk management using a device with risks of thromboembolism and bleeding.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- 2025 Thai guideline for the diagnosis and management of atrial fibrillation.Asian biomedicine : research, reviews and news · 2025Article
- Left Atrial Appendage Occlusion vs Anticoagulants in Dialysis With Atrial Fibrillation.JAMA network open · 2025Article
- Left Atrial Appendage Occlusion Compared to Anticoagulation in Patients Suffering from Atrial Fibrillation with Advanced Chronic Kidney Disease.Journal of clinical medicine · 2025Article
- Left Atrial Appendage Closure with the Watchman FLX System in a Patient with Hypertrophic Cardiomyopathy on Dialysis for End-stage Renal Failure.Internal medicine (Tokyo, Japan) · 2024Article
- Percutaneous Left Atrial Appendage Closure in Patients with Non-Valvular Atrial Fibrillation and End-Stage Renal Disease on Hemodialysis: A Case Series.Medicina (Kaunas, Lithuania) · 2024Article
- Long-term safety and efficacy of left atrial appendage occlusion in dialysis patients with atrial fibrillation: a multi-center, prospective, open label, observational study.Clinical kidney journal · 2023Article
- Atrial Fibrillation in Kidney Failure: Challenges in Risk Assessment and Anticoagulation Management.Kidney medicine · 2023Review
- Percutaneous Left Atrial Appendage Occlusion Therapy: Evolution and Growing Evidence.Reviews in cardiovascular medicine · 2023Review
- Percutaneous left atrial appendage closure: beyond the classic indications.AsiaIntervention · 2023Review
- Percutaneous Left Atrial Appendage Occlusion: What the Practising Physician Should Know.European cardiology · 2023Review
- Therapeutics of Extracellular Vesicles in Cardiocerebrovascular and Metabolic Diseases.Advances in experimental medicine and biology · 2023Article
- Some good reasons to proceed with the occlusion of the auricle.European heart journal supplements : journal of the European Society of Cardiology · 2022Article
- Long-term results of percutaneous left atrial appendage occlusion in patients with atrial fibrillation and chronic kidney disease.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2022Article
- Arrhythmias in Chronic Kidney Disease.European cardiology · 2022Review
Corrections and comments
- Erratum issued
Authors and funding
27 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients with end stage renal disease and atrial fibrillation (AF), undergoing chronic dialysis, direct oral agents are contraindicated and warfarin does not fully prevent embolic events while increasing the bleeding risk. The high hemorrhagic risk represents the main problem in this population. Aim of the study was to estimate the safety and efficacy for thromboembolic prevention of left atrial appendage (LAA) occlusion in a cohort of dialysis patients with AF and high hemorrhagic risk.
methodsNinety-two dialysis patients with AF who underwent LAA occlusion were recruited. For comparative purposes, two cohorts of dialysis patients with AF, one taking warfarin (oral anticoagulant therapy, OAT cohort, n = 114) and the other not taking any OAT (no-therapy cohort, n = 148) were included in the study. Primary endpoints were (1) incidence of peri-procedural complications, (2) incidence of 2-year thromboembolic and hemorrhagic events, (3) mortality at 2 years. In order to evaluate the effect of the LAA occlusion on the endpoints with respect to the OAT and No-therapy cohorts, a multivariable Cox regression model was applied adjusted for possible confounding factors.
resultsThe device was successfully implanted in 100% of cases. Two major peri-procedural complications were reported. No thromboembolic events occurred at 2-year follow-up. The adjusted multivariable Cox regression model showed no difference in bleeding risk in the OAT compared to the LAA occlusion cohort in the first 3 months of follow-up [HR 1.65 (95% CI 0.43-6.33)], when most of patients were taking two antiplatelet drugs. In the following 21 months the bleeding incidence became higher in OAT patients [HR 6.48 (95% CI 1.32-31.72)]. Overall mortality was greater in both the OAT [HR 2.76 (95% CI 1.31-5.86)] and No-Therapy [HR 3.09 (95% CI 1.59-5.98)] cohorts compared to LAA occlusion patients.
conclusionsThe study could open the way to a non-pharmacological option for thromboembolic protection in dialysis patients with AF and high bleeding risk.
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