ArticleJACC. Advances2026
Left Atrial Appendage Closure vs Direct Oral Anticoagulants in Atrial Fibrillation: Meta-Analysis of Randomized Trials.
Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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.
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.
Who cites it
3 citing papers in PubMed.
- Left Atrial Appendage Occlusion vs Direct Oral Anticoagulants for Atrial Fibrillation: Network Meta-Analyses.JACC. Advances · 2026Article
- Left Atrial Appendage Occlusion vs. Oral Anticoagulants: Current Evidence and Debates.Journal of clinical medicine · 2026Review
- Left Atrial Appendage Closure and Direct Oral Anticoagulation: Understanding the Trade-Off.JACC. Advances · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLeft atrial appendage closure (LAAC) is a potential alternative to oral anticoagulation for stroke prevention in atrial fibrillation.
objectivesWe performed an updated meta-analysis of randomized controlled trials comparing LAAC with direct oral anticoagulants (DOACs) for efficacy and safety.
methodsWe systematically searched from January 1, 2012, to April 3, 2026, for randomized controlled trials comparing percutaneous LAAC with DOACs in patients with atrial fibrillation. Using the longest available follow-up from each trial, we pooled efficacy and bleeding outcomes, including stroke, death, and intracranial hemorrhage (ICH), and pooled relative risks (RRs) with random-effects models.
resultsFour randomized trials involving 5,890 patients were included, with 2,949 assigned to LAAC and 2,941 to DOAC therapy. The median follow-up ranged from 36 to 42 months. There were no significant differences in all stroke, hemorrhagic stroke, systemic embolism, all-cause death, or cardiovascular death. LAAC was associated with a numerically higher risk of ischemic stroke (RR: 1.36; 95% CI: 0.99-1.89; P = 0.06), which became significant (RR: 1.45; 95% CI: 1.03-2.06; P = 0.03) after exclusion of the OPTION trial. LAAC significantly reduced all nonmajor (RR: 0.53; 95% CI: 0.40-0.71; P < 0.0001) and nonprocedure-related major (RR: 0.79; 95% CI: 0.65-0.97; P = 0.02) and nonmajor bleeding (RR: 0.47; 95% CI: 0.39-0.57; P < 0.0001), whereas risks of all major bleeding (RR: 0.97; 95% CI: 0.81-1.17; P = 0.77) and ICH (RR 0.76; 95% CI: 0.45-1.26; P = 0.28) were similar.
conclusionsCompared with DOACs, LAAC reduced nonprocedure-related major and nonmajor bleeding, potentially at the cost of an increased risk of ischemic stroke, without significant differences in major bleeding or ICH.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.