Evidence map›Paper›PMID 38440888›Full record

ArticleCirculation. Cardiovascular quality and outcomes2024

Patient Characteristics Associated With Using Transcatheter Left Atrial Appendage Occlusion Versus Oral Anticoagulants for Atrial Fibrillation.

Kueiyu Joshua Lin, Daniel E Singer, Jerry Avorn, E Kevin Heist, Sushama Kattinakere Sreedhara, Priyanka Anand, Yichi Zhang, Theodore N Tsacogianis, Sebastian Schneeweiss

Open access · greenAbstract read
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 21% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. 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

9 authors at 2 institutions in 1 country.

Kueiyu Joshua LinDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA (K.J.L., J.A., S.K.S., P.A., Y.Z., T.N.T., S.S.).ORCID 0000-0003-4564-3715
Daniel E SingerDivision of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (K.J.L., D.E.S.); Division of Cardiology and Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA.ORCID 0000-0001-6145-4848
Jerry AvornDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA (K.J.L., J.A., S.K.S., P.A., Y.Z., T.N.T., S.S.).ORCID 0000-0003-0255-2346
Sushama Kattinakere SreedharaDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA (K.J.L., J.A., S.K.S., P.A., Y.Z., T.N.T., S.S.).ORCID 0000-0002-9182-304X
Priyanka AnandDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA (K.J.L., J.A., S.K.S., P.A., Y.Z., T.N.T., S.S.).ORCID 0000-0002-0945-4100
Yichi ZhangDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA (K.J.L., J.A., S.K.S., P.A., Y.Z., T.N.T., S.S.).ORCID 0000-0003-4885-9028
Theodore N TsacogianisDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA (K.J.L., J.A., S.K.S., P.A., Y.Z., T.N.T., S.S.).ORCID 0009-0003-4529-5287
Sebastian SchneeweissDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA (K.J.L., J.A., S.K.S., P.A., Y.Z., T.N.T., S.S.).ORCID 0000-0003-2575-467X
Brigham and Women's Hospital · USMassachusetts General Hospital · US

Funding

Effectiveness and Safety of Transcatheter Left Atrial Appendage Occlusion vs. Anticoagulation in Older Adults with Atrial Fibrillation and Alzheimer's Disease and Related dementiasR01AG075335 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI LIN, JOSHUA K · 2022 to 2025
$3.0M
Developing dynamic prognostic and risk-stratification models for informing prescribing decisions in older adults with Coronavirus Disease 2019RF1AG063381 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI LIN, JOSHUA K · 2019 to 2021
$2.7M
NIA NIH HHS R01 AG075335NIA NIH HHS RF1 AG063381
6 · The paper itself

Abstract

backgroundTranscatheter left atrial appendage occlusion (LAAO) is an alternative to oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation, but the predictors of LAAO use in routine care are unclear. We aimed to assess the utilization trends of LAAO and compare the change in characteristics of LAAO users versus OACs since its marketing.

methodsUsing the US Medicare claims database (March 15, 2015, to December 31, 2020), we identified patients with atrial fibrillation, ≥65 years, and CHA

resultsThere were 30 058 LAAO recipients (mean age, 77.74 years; female, 42.1%) and 792 600 OAC initiators (mean age, 78.48; female, 53.3%). In 2020, patients had higher odds of initiating LAAO use than in 2015 (0.52 versus 9.32%; adjusted odds ratio [aOR], 13.64 [95% CI, 12.56-14.81]). Old age (ie, >85 versus 65-75 years; aOR, 0.84 [95% CI, 0.80-0.88]), female sex (aOR, 0.74 [95% CI, 0.71-0.76]), Black race (aOR, 0.63 [95% CI, 0.58-0.68]) versus White race, and Medicaid eligibility (aOR, 0.61 [95% CI, 0.58-0.64]) were associated with lower odds of receiving LAAO. Among clinical characteristics, frailty, cancer, fractures, and venous thromboembolism were associated with lower odds of LAAO use, while history of intracranial and extracranial bleeding, coagulopathy, and falls were associated with higher odds of receiving LAAO.

conclusionsAmong patients with atrial fibrillation receiving stroke-preventive therapy, LAAO use increased rapidly from 2015 to 2020 and was positively associated with the risk factors for OAC complications but negatively associated with old age, advanced frailty, and cancer. Black race and female sex were associated with a lower likelihood of receiving LAAO.

Indexed as

Atrial AppendageAtrial FibrillationFrailtyNeoplasmsStrokeAgedAnticoagulantsFemaleHumansMaleMedicareTreatment OutcomeUnited StatesAnticoagulantsanticoagulantsatrial fibrillationfalls, accidentalischemic stroke

Identifiers

PMID38440888
PMCPMC10950527
OpenAlexW4392471107

What OpenQuestion holds

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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.