ArticleJACC. Cardiovascular interventions2023
DAPT Is Comparable to OAC Following LAAC With WATCHMAN FLX: A National Registry Analysis.
Article in JACC. Cardiovascular interventions, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Antithrombotic strategies and DOAC dosing following left atrial appendage occlusion: a network meta-analysis.European heart journal. Cardiovascular pharmacotherapy · 2026Pooled it
- Patterns of antithrombotic treatment after left atrial appendage occlusion.Heart rhythm · 2026Article
- Direct oral anticoagulant dose vs dual antiplatelet therapy after left atrial appendage closure in patients with nonvalvular atrial fibrillation: a systematic review and meta-analysis.Journal of thrombosis and thrombolysis · 2026Review
- Percutaneous left atrial appendage closure for stroke prevention: current challenges and future perspectives.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Review
- Outcomes of simplified left atrial appendage occlusion using the WATCHMAN FLX device: the ROSE-FLX study.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 · 2026Article
- Antithrombotic Therapy after Structural Heart Disease Intervention.Journal of neuroendovascular therapy · 2026Review
- Left atrial appendage occlusion in patients with cancer.Journal of thrombosis and thrombolysis · 2025Review
- Left Atrial Appendage Occlusion Using the Amplatzer Amulet Device in High-Risk Patients With Atrial Fibrillation Undergoing Transcatheter Aortic Valve Intervention: A Randomized Pilot Study.Structural heart : the journal of the Heart Team · 2025Article
- Atrial cardiomyopathy delays the endothelialization process of left atrial appendage occluders.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
- Left Atrial Appendage Occlusion: Persistent Gaps.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- 2025 SCAI/HRS Clinical Practice Guidelines on Transcatheter Left Atrial Appendage Occlusion.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- SCAI/HRS Technical Review on Transcatheter Left Atrial Appendage Occlusion.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Quantitative considerations for choosing between Amulet and Watchman FLX and management of device related complications.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Watchman vs. Amulet for Left Atrial Appendage Closure: Current Evidence and Future Perspectives.Journal of clinical medicine · 2024Review
- A Comprehensive Review of Percutaneous and Surgical Left Atrial Appendage Occlusion.Journal of cardiovascular development and disease · 2024Review
- Left Atrial Appendage Occlusion and Post-procedural Antithrombotic Management.Journal of clinical medicine · 2024Review
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11 authors at 9 institutions in 1 country.
Funding
Abstract
backgroundLeft atrial appendage occlusion (LAAO) is an approved alternative for stroke prevention in atrial fibrillation for patients with an "appropriate rationale" to avoid long-term oral anticoagulation (OAC). Many patients undergoing LAAO are at high risk of bleeding.
objectivesThis study sought to investigate whether dual antiplatelet therapy (DAPT) is a safe alternative to OAC (direct oral anticoagulation [DOAC] or warfarin) with aspirin after LAAO.
methodsUsing National Cardiovascular Data Registry LAAO registry data, patients undergoing Watchman FLX (Boston Scientific) implantation (August 5, 2020-September 30, 2021) were included in 1:1 propensity-matched analyses comparing discharge medication regimens (DAPT, DOAC/aspirin, or warfarin/aspirin). A composite endpoint (death, stroke, major bleeding, and systemic embolism), its components, and device-related thrombus between discharge and 45 days were evaluated.
resultsIn 49,968 patients implanted with the Watchman FLX during the study period, the mean age was 77 years, and 40% were women. Postimplant DOAC/aspirin was prescribed in 24,497 patients, warfarin/aspirin in 3,913, and DAPT in 4,155. DAPT patients had more comorbid conditions than patients receiving OAC/aspirin. After propensity score matching, the 45-day composite endpoint rates were similar among the groups (DAPT = 3.44% vs DOAC/aspirin: 4.06%; P = 0.13 and DAPT = 3.23% vs warfarin/aspirin: 3.08%; P = 0.75). Death, stroke, and device-related thrombus were also similar; major bleeding was slightly increased in DOAC/aspirin patients (DAPT = 2.48% vs DOAC/aspirin = 3.25%; P = 0.04 and DAPT = 2.25% vs warfarin/aspirin = 2.22%; P = 0.93).
conclusionsIn a large registry, DAPT had a similar safety profile compared with current Food and Drug Administration-approved postimplant drug regimens of OAC with aspirin following LAAO with the Watchman FLX. Shared decision making for nonpharmacologic stroke prevention should include a discussion of postprocedure medical therapy options.
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