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Change in hospitalization rates following transcatheter left atrial appendage occlusion
INTRODUCTION: Left atrial appendage occlusion (LAAO) is recommended in patients with non-valvular atrial fibrillation (AF) who have contraindications to or are intolerant of long-term oral anticoagulants (OAC), but its impact on hospitalization rates has not been well described. The objective of our...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9487831/ https://www.ncbi.nlm.nih.gov/pubmed/36161215 http://dx.doi.org/10.5114/amsad.2021.111405 |
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author | Mohammed, Moghniuddin Kattel, Sharma Ahsan, Irfan Samdani, Abdul J. Chand, Swati Rai, Devesh Bandyopadhyay, Dhrubajyoti Ranka, Sagar Noheria, Amit Gupta, Sanjaya K. Sheldon, Seth H. Rao, Mohan Aronow, Wilbert S. Freeman, James V. Reddy, Madhu |
author_facet | Mohammed, Moghniuddin Kattel, Sharma Ahsan, Irfan Samdani, Abdul J. Chand, Swati Rai, Devesh Bandyopadhyay, Dhrubajyoti Ranka, Sagar Noheria, Amit Gupta, Sanjaya K. Sheldon, Seth H. Rao, Mohan Aronow, Wilbert S. Freeman, James V. Reddy, Madhu |
author_sort | Mohammed, Moghniuddin |
collection | PubMed |
description | INTRODUCTION: Left atrial appendage occlusion (LAAO) is recommended in patients with non-valvular atrial fibrillation (AF) who have contraindications to or are intolerant of long-term oral anticoagulants (OAC), but its impact on hospitalization rates has not been well described. The objective of our study is to describe the incidence of all-cause, bleeding-related, and thrombosis-related hospitalizations before and after LAAO. MATERIAL AND METHODS: We used the Nationwide Readmission Database to include patients aged ≥ 18 years with a diagnosis of AF who underwent transcatheter LAAO during the months of February-November in each year between 2016 and 2018. Patients who died during the index procedure or had missing length of hospital stay or mortality information were excluded. RESULTS: A total of 27,633 patients were included (median age: 77 years, 41% female) with an average pre- and post-LAAO monitoring period of 6.5 and 5.5 months respectively. Of these, 10,808 (39.1%) patients had one or more admissions prior to the procedure compared to 7,196 (26.0%) after the procedure. There was a 26% reduction in incidence of all-cause admissions (rate ratio (RR) = 0.74, 95% confidence interval (CI): 0.71–0.76; p < 0.001), 49% reduction in bleeding-related admissions (RR = 0.51, 95% CI: 0.48–0.55; p < 0.001), and 71% reduction in thrombosis-related readmissions (RR = 0.29, 95% CI: 0.26–0.33; p < 0.001) after LAAO. CONCLUSIONS: In a contemporary, nationally representative dataset, we found that LAAO is associated with a significant decrease in all-cause, bleeding-related, and thrombosis-related admissions. These findings lend support to the current use of transcatheter LAAO in clinical practice for patients with contraindications to OAC and/or at high risk of bleeding. |
format | Online Article Text |
id | pubmed-9487831 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-94878312022-09-22 Change in hospitalization rates following transcatheter left atrial appendage occlusion Mohammed, Moghniuddin Kattel, Sharma Ahsan, Irfan Samdani, Abdul J. Chand, Swati Rai, Devesh Bandyopadhyay, Dhrubajyoti Ranka, Sagar Noheria, Amit Gupta, Sanjaya K. Sheldon, Seth H. Rao, Mohan Aronow, Wilbert S. Freeman, James V. Reddy, Madhu Arch Med Sci Atheroscler Dis Clinical Research INTRODUCTION: Left atrial appendage occlusion (LAAO) is recommended in patients with non-valvular atrial fibrillation (AF) who have contraindications to or are intolerant of long-term oral anticoagulants (OAC), but its impact on hospitalization rates has not been well described. The objective of our study is to describe the incidence of all-cause, bleeding-related, and thrombosis-related hospitalizations before and after LAAO. MATERIAL AND METHODS: We used the Nationwide Readmission Database to include patients aged ≥ 18 years with a diagnosis of AF who underwent transcatheter LAAO during the months of February-November in each year between 2016 and 2018. Patients who died during the index procedure or had missing length of hospital stay or mortality information were excluded. RESULTS: A total of 27,633 patients were included (median age: 77 years, 41% female) with an average pre- and post-LAAO monitoring period of 6.5 and 5.5 months respectively. Of these, 10,808 (39.1%) patients had one or more admissions prior to the procedure compared to 7,196 (26.0%) after the procedure. There was a 26% reduction in incidence of all-cause admissions (rate ratio (RR) = 0.74, 95% confidence interval (CI): 0.71–0.76; p < 0.001), 49% reduction in bleeding-related admissions (RR = 0.51, 95% CI: 0.48–0.55; p < 0.001), and 71% reduction in thrombosis-related readmissions (RR = 0.29, 95% CI: 0.26–0.33; p < 0.001) after LAAO. CONCLUSIONS: In a contemporary, nationally representative dataset, we found that LAAO is associated with a significant decrease in all-cause, bleeding-related, and thrombosis-related admissions. These findings lend support to the current use of transcatheter LAAO in clinical practice for patients with contraindications to OAC and/or at high risk of bleeding. Termedia Publishing House 2021-12-10 /pmc/articles/PMC9487831/ /pubmed/36161215 http://dx.doi.org/10.5114/amsad.2021.111405 Text en Copyright: © 2021 Termedia & Banach https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Clinical Research Mohammed, Moghniuddin Kattel, Sharma Ahsan, Irfan Samdani, Abdul J. Chand, Swati Rai, Devesh Bandyopadhyay, Dhrubajyoti Ranka, Sagar Noheria, Amit Gupta, Sanjaya K. Sheldon, Seth H. Rao, Mohan Aronow, Wilbert S. Freeman, James V. Reddy, Madhu Change in hospitalization rates following transcatheter left atrial appendage occlusion |
title | Change in hospitalization rates following transcatheter left atrial appendage occlusion |
title_full | Change in hospitalization rates following transcatheter left atrial appendage occlusion |
title_fullStr | Change in hospitalization rates following transcatheter left atrial appendage occlusion |
title_full_unstemmed | Change in hospitalization rates following transcatheter left atrial appendage occlusion |
title_short | Change in hospitalization rates following transcatheter left atrial appendage occlusion |
title_sort | change in hospitalization rates following transcatheter left atrial appendage occlusion |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9487831/ https://www.ncbi.nlm.nih.gov/pubmed/36161215 http://dx.doi.org/10.5114/amsad.2021.111405 |
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