Evidence map›Paper›PMID 39216123›Full record

SynthesisClinics (Sao Paulo, Brazil)2024

Efficacy and safety of left atrial appendage closure procedure in patients with non-valvular atrial fibrillation with contraindication and/or failure for oral anticoagulants: A systematic review and meta-analysis.

Ricardo Dos Santos Simões, Aline Frossard Ribeiro Bortoluzzi, Janaina Cardoso Nunes Marinho, Julia Simões Corrêa Galendi, Wanderley Marques Bernardo

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Clinics (Sao Paulo, Brazil), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Surgical Methods and Devices for Atrial Fibrillation.Reviews in cardiovascular medicine · 2025
    Review
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

5 authors.

Ricardo Dos Santos SimõesNúcleo de Avaliação de Tecnologias em Saúde da Unimed do Brasil, Unimed do Brasil, São Paulo, SP, Brazil.
Aline Frossard Ribeiro BortoluzziNúcleo de Avaliação de Tecnologias em Saúde da Unimed do Brasil, Unimed do Brasil, São Paulo, SP, Brazil.
Janaina Cardoso Nunes MarinhoNúcleo de Avaliação de Tecnologias em Saúde da Unimed do Brasil, Unimed do Brasil, São Paulo, SP, Brazil. Electronic address: janaina.marinho@unimed.coop.br.
Julia Simões Corrêa GalendiNúcleo de Avaliação de Tecnologias em Saúde da Unimed do Brasil, Unimed do Brasil, São Paulo, SP, Brazil.
Wanderley Marques BernardoNúcleo de Avaliação de Tecnologias em Saúde da Unimed do Brasil, Unimed do Brasil, São Paulo, SP, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWith the aim of reducing the risk of Cerebrovascular Accident (CVA) in patients with Non-Valvular Atrial Fibrillation (NVAF), Left Atrial Appendage Occlusion (LAAO) devices are emerging as an alternative to oral anticoagulants.

objectiveTo analyze the efficacy and safety of the LAAO procedure in patients with NVAF and contraindications and/or failure for oral anticoagulants.

methodThe search for evidence was carried out in the electronic databases Medline and Embase till January 2024. Additional searches were conducted on Google Scholar. The clinical trials registry database was also consulted. Two blinded investigators performed the search, study selection, and data collection, and assessed quality and risk of bias using the Cochrane tool for randomized clinical trials. Meta-analyses of eligible trials were performed using RevMan 5.4.1 software. The random effects model was used for all analyses.

resultsFive articles were selected, among which three were non-inferiority randomized clinical trials that analyzed the performance and safety of LAAO devices compared to the use of Vitamin K Antagonists (AVKs) or Novel Oral Anticoagulants (NOACs). No randomized clinical trials were found that analyzed populations with absolute contraindications to oral anticoagulants. Having as primary outcomes analyzed the occurrence of stroke (ischemic or hemorrhagic), cardiovascular or unexplained death and systemic embolism, the non-inferiority of the LAAO procedure compared to the use of oral anticoagulants was verified.

conclusionsFor patients with an absolute contraindication to anticoagulation and/or failure to use oral anticoagulants, evidence for the use of LAAO devices is scarce.

Indexed as

AnticoagulantsAtrial AppendageAtrial FibrillationAdministration, OralContraindications, DrugHumansLeft Atrial Appendage ClosureRandomized Controlled Trials as TopicStrokeTreatment OutcomeAnticoagulantsAtrial fibrillationLeft atrial appendage closureMeta-analysisSystematic review

Identifiers

PMID39216123
PMCPMC11402378

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.