Direct oral anticoagulants vs dual antiplatelet therapy following left atrial appendage closure in atrial fibrillation.
Wulamiding Kaisaier, Zixuan Xu, Min Ye et al.
✦ AI-curated · Sources linked
In 30 seconds
This meta-analysis compared the efficacy and safety of direct oral anticoagulants (DOACs) versus dual antiplatelet therapy (DAPT) in patients with atrial fibrillation following left atrial appendage closure (LAAC). Involving 704 patients from 3 randomized controlled trials, the study found that DOACs significantly reduced the risk of device-related thrombosis and bleeding compared to DAPT, with no significant differences in stroke or all-cause mortality.
Key findings
- DOACs were associated with a significantly lower risk of device-related thrombosis (OR = 0.16; 95% CI: 0.05-0.57).
- Major bleeding risk was significantly lower with DOACs compared to DAPT (OR = 0.46; 95% CI: 0.26-0.81).
- Minor bleeding was also significantly reduced with DOACs (OR = 0.59; 95% CI: 0.38-0.92).
- No significant differences were found in stroke (OR = 0.46; 95% CI: 0.07-3.13) or all-cause mortality (OR = 0.60; 95% CI: 0.23-1.54).
Why it matters
The findings suggest that DOACs may provide a safer short-term antithrombotic strategy following LAAC in patients with atrial fibrillation, potentially reducing the risk of complications associated with bleeding and thrombosis.