Evidence map›Paper›PMID 38565524›Full record

ArticlePharmacoepidemiology and drug safety2024

Percutaneous left atrial appendage occlusion and risk of stroke, hospitalized bleeding and death in Medicare beneficiaries.

Wendy Wang, Lin Yee Chen, Rob F Walker, Alvaro Alonso, Faye L Norby, Kamakshi Lakshminarayan, Pamela L Lutsey

Open access · hybridAbstract read
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 39% 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

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

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

7 authors at 2 institutions in 1 country.

Wendy WangDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.ORCID 0000-0001-6025-0173
Lin Yee ChenLillehei Heart Institute and Department of Medicine (Cardiovascular Division), University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Rob F WalkerDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Alvaro AlonsoDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Faye L NorbyDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Kamakshi LakshminarayanDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Pamela L LutseyDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
University of Minnesota · USEmory University · US

Funding

Cardiovascular Disease Epidemiology &Prevention TrngT32HL007779 · NHLBI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI PAMELA L. Lutsey, JAMES S PANKOW · 1994 to 2026
$9.3M
Mentoring and Research to ClassifyAtrial CardiomyopathyK24HL155813 · NHLBI · UNIVERSITY OF MINNESOTA · PI Lin Yee Chen · 2021 to 2026
$770k
Sudden Death Associated with Substance UseK01HL164764 · NHLBI · UNIVERSITY OF MINNESOTA · PI Faye Norby · 2022 to 2026
$706k
Mentoring and Research in Patient-Oriented Cardiovascular PharmacoepidemiologyK24HL159246 · NHLBI · UNIVERSITY OF MINNESOTA · PI PAMELA L. Lutsey · 2021 to 2026
$644k
Mentoring in patient-oriented atrial fibrillation and cardiovascular researchK24HL148521 · NHLBI · EMORY UNIVERSITY · PI ALONSO, ALVARO · 2019 to 2023
$593k
NHLBI NIH HHS K01 HL164764NHLBI NIH HHS K24 HL148521NHLBI NIH HHS K24 HL155813NHLBI NIH HHS K24 HL159246NHLBI NIH HHS T32 HL007779
6 · The paper itself

Abstract

purposeAmong patients with atrial fibrillation (AF), a nonpharmacologic option (e.g., percutaneous left atrial appendage occlusion [LAAO]) is needed for patients with oral anticoagulant (OAC) contraindications. Among beneficiaries in the Medicare fee-for-service coverage 20% sample databases (2015-18) who had AF and an elevated CHA

methodsPatients undergoing percutaneous LAAO were matched to up to five OAC users by sex, age, date of enrollment, index date, CHA

resultsMedian follow-up was 10.3 months. After multivariable adjustments, no significant difference for risk of stroke or death was noted when patients with percutaneous LAAO were compared with OAC users (HRs [95% CIs]: 1.14 [0.86-1.52], 0.98 [0.86-1.10]). There was a 2.94-fold (95% CI: 2.50-3.45) increased risk for hospitalized bleeding for percutaneous LAAO compared with OAC use. Among patients 65 to <78 years old, those undergoing percutaneous LAAO had higher risk of stroke compared with OAC users. No association was present in those ≥78 years.

conclusionIn this analysis of real-world AF patients, percutaneous LAAO versus OAC use was associated with similar risk of death, nonsignificantly elevated risk of stroke, and an elevated risk of bleeding in the post-procedural period. Overall, these results support results of randomized trials that percutaneous LAAO may be an alternative to OAC use for patients with contraindications.

Indexed as

Atrial AppendageAtrial FibrillationStrokeAgedAnticoagulantsFemaleHemorrhageHumansMaleMedicareTreatment OutcomeUnited StatesAnticoagulantsatrial fibrillationhospitalized bleedingpercutaneous LAAOstroke

Identifiers

PMID38565524
PMCPMC10996071
OpenAlexW4393868615

What OpenQuestion holds

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Registered trials

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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.