Evidence map›Paper›PMID 40264015›Full record

SynthesisBMC cardiovascular disorders2025

Optimal duration of anticoagulation after left atrial appendage closure: a systematic review and meta-analysis.

Xuan Lu, Zhenyu Yang, Wei Fang, Xiaona Niu, Qiuhe Wang, Yan Li

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Left Atrial Appendage Occlusion in Cancer-Associated Atrial Fibrillation: Who, When, and How to Manage Antithrombotic Therapy.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    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

6 authors.

Xuan LuDepartment of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
Zhenyu YangDepartment of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
Wei FangDepartment of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
Xiaona NiuDepartment of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.
Qiuhe WangDepartment of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China. qiuhewang@fmmu.edu.cn.
Yan LiDepartment of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China. profleeyan@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLeft atrial appendage closure (LAAC) has become the treatment of choice for stroke prevention in patients with nonvalvular atrial fibrillation who are at high risk of bleeding or with contraindications for anticoagulation. However, the optimal duration of anticoagulation after LAAC remains uncertain. The aim of this study was to evaluate the optimal duration of treatment with novel oral anticoagulants (NOACs) after LAAC.

methodWe searched the PubMed, Embase, Cochrane Library, and Web of Science databases for studies related to LAAC published from inception to 20 December 2023, and performed a meta-analysis comparing the efficacy and safety of 45-day and 3-month postoperative NOAC treatment using R4.3.1 software.

resultsA total of 14 studies were included in this study, of which 4 were prospective cohort studies and 10 were retrospective cohort studies. The incidence of stroke or transient ischaemic attack (0.018 [95% CI: 0.007-0.033] in the 3-month group and 0.005 [95% CI: 0.001-0.011] in the 45-day group; P = 0.07) and the incidence of device-related thrombus (0.025 [95% CI: 0.002-0.065] in the 3-month group and 0.020 [ 95% CI: 0.007-0.037] in the 45-day group; P = 0.81) were not significantly different. However, the incidence of major bleeding was significantly greater in the 3-month group than in the 45-day group (0.033 [95% CI: 0.018-0.053] in the 3-month group and 0.003 [95% CI: 0.000-0.008] in the 45-day group; P < 0.01).

conclusionsCompared with the 3-month scheme, 45 days of postoperative anticoagulation significantly reduced the risk of major bleeding in patients without compromising the efficacy of preventing stroke or transient ischaemic attack and device-related thrombus.

trial registrationOur meta-analysis was registered in the PROSPERO international database (CRD42024524661).

Indexed as

AnticoagulantsAtrial AppendageAtrial FibrillationCardiac CatheterizationStrokeAdministration, OralAgedAged, 80 and overDrug Administration ScheduleFemaleHemorrhageHumansLeft Atrial Appendage ClosureMaleMiddle AgedRisk AssessmentAnticoagulantsLeft atrial appendage closureMajor bleedingNovel oral anticoagulantsStroke

Identifiers

PMID40264015
PMCPMC12016058

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.