Ischemic stroke less often disabling or fatal with left atrial appendage closure than direct oral anticoagulant prophylaxis<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b><\/p>\n
<\/b><\/p>\n
WEDNESDAY, Dec. 6, 2023 (HealthDay News) — For patients with atrial fibrillation, ischemic strokes (IS) are less often fatal or disabling with left atrial appendage closure (LAAC) prophylaxis than with direct oral anticoagulant (DOAC) prophylaxis, according to a study published online Nov. 22 in JACC: Clinical Electrophysiology<\/em>.<\/p>\n Mohit K. Turagam, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues conducted a retrospective analysis of consecutive patients undergoing LAAC at eight centers who developed an IS (ISLAAC<\/sub>; 125 patients) compared with 322 contemporaneous patients who developed IS during DOAC treatment (ISDOAC<\/sub>).<\/p>\n The researchers found that at both hospital discharge and three months later, strokes were less frequently disabling\/fatal with ISLAAC<\/sub> than ISDOAC<\/sub> (38.3 versus 70.3 percent and 33.3 versus 56.2 percent, respectively). After propensity score matching, differences in stroke severity persisted. In a multivariate regression analysis, independent associations were seen for ISLAAC<\/sub> with fewer disabling\/fatal strokes at discharge and three months and with fewer deaths at three months (odds ratios, 0.22, 0.25, and 0.28, respectively).<\/p>\n “Both of these strategies, LAAC and blood thinners, are overall effective in preventing stroke in patients with a-fib, but strokes can infrequently still occur with either prevention strategy,” coauthor Vivek Reddy, M.D., also from the Icahn School of Medicine at Mount Sinai, said in a statement. “These data indicate that these breakthrough strokes are considerably worse when they occur while taking blood thinners — the strokes are more severe and more often fatal — than after LAAC.”<\/p>\n Several authors disclosed ties to the medical technology industry.<\/p>\n Abstract\/Full Text (subscription or payment may be required)<\/a><\/p>\n <\/i><\/p>\n