دورية أكاديمية
أعرض في EDS

Long-term Event Reduction After Left Atrial Appendage Closure. Results of the Iberian Registry II.

التفاصيل البيبلوغرافية
العنوان: Long-term Event Reduction After Left Atrial Appendage Closure. Results of the Iberian Registry II.
المؤلفون: López-Mínguez JR; Servicio de Cardiología, Hospital Infanta Cristina, Badajoz, Spain. Electronic address: lopez-minguez@hotmail.com., Nogales-Asensio JM; Servicio de Cardiología, Hospital Infanta Cristina, Badajoz, Spain., Infante De Oliveira E; Serviço de Cardiologia, Hospital de Santa María, Lisboa, Portugal., De Gama Ribeiro V; Serviço de Cardiologia, Centro Hospitalar de Vila Nova de Gaia, Oporto, Portugal., Ruiz-Salmerón R; Servicio de Cardiología, Hospital Virgen de la Macarena, Sevilla, Spain., Arzamendi-Aizpurua D; Servicio de Cardiología, Hospital Santa Creu i San Pau, Barcelona, Spain., Costa M; Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Gutiérrez-García H; Servicio de Cardiología, Hospital Clínico de Valladolid, Valladolid, Spain., Fernández-Díaz JA; Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain., Martín-Yuste V; Servicio de Cardiología, Hospital Clínic de Barcelona, Barcelona, Spain., Rama-Merchán JC; Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain., Moreno-Gómez R; Servicio de Cardiología, Hospital La Paz, Madrid, Spain., Benedicto-Buendía A; Servicio de Cardiología, Hospital La Princesa, Madrid, Spain., Íñiguez-Romo A; Servicio de Cardiología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
المصدر: Revista espanola de cardiologia (English ed.) [Rev Esp Cardiol (Engl Ed)] 2019 Jun; Vol. 72 (6), pp. 449-455. Date of Electronic Publication: 2018 May 10.
نوع المنشور: Journal Article; Multicenter Study
اللغة: English; Spanish; Castilian
بيانات الدورية: Publisher: Elsevier Doyma Country of Publication: Spain NLM ID: 101587954 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1885-5857 (Electronic) Linking ISSN: 18855857 NLM ISO Abbreviation: Rev Esp Cardiol (Engl Ed) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Barcelona : Elsevier Doyma
مواضيع طبية MeSH: Registries* , Septal Occluder Device*, Atrial Appendage/*surgery , Atrial Fibrillation/*surgery , Cardiac Surgical Procedures/*methods , Stroke/*prevention & control, Aged ; Aged, 80 and over ; Atrial Appendage/diagnostic imaging ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Echocardiography, Transesophageal ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Portugal/epidemiology ; Prospective Studies ; Spain/epidemiology ; Stroke/epidemiology ; Stroke/etiology ; Time Factors ; Treatment Outcome
مستخلص: Introduction and Objectives: Many patients with nonvalvular atrial fibrillation are still left without protection due to a contraindication for anticoagulants. This study aimed to establish the occurrence of stroke and major bleeding events in patients with nonvalvular atrial fibrillation and left atrial appendage closure with long-term follow-up and to explore the factors associated with higher long-term mortality.
Methods: Analysis of a multicenter single cohort prospectively recruited from 2009 to 2015. Thromboembolic and bleeding events were compared with those expected from CHA 2 DS 2 -VASc and HAS-BLED scores. Multivariate analysis examined variables associated with mortality during follow-up.
Results: A total of 598 patients (1093 patient-years) with a contraindication for anticoagulants were recruited (median 75.4 years). The success rate of left atrial appendage closure device implantation was 95.8%. Thirty patients (5%) experienced periprocedural complications. The rate of events (per 100 patient-years) during follow-up (mean 22.9 months; median 16.1 months) was as follows: death 7.0%; ischemic stroke 1.6% (vs 8.5% expected according to CHA 2 DS 2 -VASc; P < .001); intracranial hemorrhage 0.8%; gastrointestinal bleeding 3.2%; severe bleeding 3.9% (vs 6.3% expected by HAS-BLED, P = .002). These results were improved in the subgroup of 176 patients with follow-up > 24 months (mean follow-up 46.6 months, 683 patient-years) for severe bleeding 2.6% (vs 6.3% expected by HAS-BLED, P < .033). The factors significantly associated with higher mortality were age (HR, 1.1), intracranial hemorrhage (HR, 6.8), and stroke during follow-up (HR, 2.7).
Conclusions: Left atrial appendage closure significantly reduced the incidence of stroke and bleeding events and the benefit was maintained. Intracranial hemorrhage, age and stroke were associated with higher mortality.
(Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
فهرسة مساهمة: Keywords: Bleeding; Cierre de orejuela izquierda; Fibrilación auricular no valvular; Hemorragia; Ictus; Left atrial appendage closure; Mortalidad; Mortality; Nonvalvular atrial fibrillation; Stroke
تواريخ الأحداث: Date Created: 20180515 Date Completed: 20191210 Latest Revision: 20191217
رمز التحديث: 20221213
DOI: 10.1016/j.rec.2018.03.017
PMID: 29754808
قاعدة البيانات: MEDLINE
الوصف
تدمد:1885-5857
DOI:10.1016/j.rec.2018.03.017