Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2021
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
_version_ 1784792527631548416
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
work_keys_str_mv AT mohammedmoghniuddin changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT kattelsharma changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT ahsanirfan changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT samdaniabdulj changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT chandswati changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT raidevesh changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT bandyopadhyaydhrubajyoti changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT rankasagar changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT noheriaamit changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT guptasanjayak changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT sheldonsethh changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT raomohan changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT aronowwilberts changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT freemanjamesv changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion
AT reddymadhu changeinhospitalizationratesfollowingtranscatheterleftatrialappendageocclusion