Outcomes on safety and efficacy of left atrial appendage occlusion in end stage renal disease patients undergoing dialysis.

Journal of Nephrology
Simonetta GenovesiPatrizio Mazzone

Abstract

In patients with end stage renal disease and atrial fibrillation (AF), undergoing chronic dialysis, direct oral agents are contraindicated and warfarin does not fully prevent embolic events while increasing the bleeding risk. The high hemorrhagic risk represents the main problem in this population. Aim of the study was to estimate the safety and efficacy for thromboembolic prevention of left atrial appendage (LAA) occlusion in a cohort of dialysis patients with AF and high hemorrhagic risk. Ninety-two dialysis patients with AF who underwent LAA occlusion were recruited. For comparative purposes, two cohorts of dialysis patients with AF, one taking warfarin (oral anticoagulant therapy, OAT cohort, n = 114) and the other not taking any OAT (no-therapy cohort, n = 148) were included in the study. Primary endpoints were (1) incidence of peri-procedural complications, (2) incidence of 2-year thromboembolic and hemorrhagic events, (3) mortality at 2 years. In order to evaluate the effect of the LAA occlusion on the endpoints with respect to the OAT and No-therapy cohorts, a multivariable Cox regression model was applied adjusted for possible confounding factors. The device was successfully implanted in 100% of cases. Two major peri-p...Continue Reading

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Citations

Nov 13, 2020·Expert Review of Cardiovascular Therapy·Alexandru BurlacuAdrian Covic
Nov 19, 2020·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Malini RiddleHarsha Nagarajarao
Mar 2, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·An S De Vriese, Gunnar Heine

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Methods Mentioned

BETA
nuclear magnetic resonance

Clinical Trials Mentioned

NCT02933697
NCT02942407
NCT03446794

Software Mentioned

AXADIA
SAS
STATA

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