Left Atrial Appendage Occlusion Among Cancer Patients With Atrial Fibrillation: A Systematic Review and Updated Meta-Analysis.
Luisalice Mendes Afonso, Giuseppe De Bacco Gava, Hemilly da Silva Pires et al.
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In 30 seconds
This systematic review and updated meta-analysis assessed long-term outcomes after left atrial appendage occlusion (LAAO) in patients with atrial fibrillation and cancer. It included 9 studies with 209,325 patients; mean age was 77 years and 39.3% were female. Compared with patients without cancer, cancer was associated with higher long-term all-cause mortality (HR 1.64, 95% CI 1.20 to 2.23, p = 0.002). The analysis found no significant association with long-term stroke or bleeding, and outcomes did not differ significantly between active and historical cancer subgroups.
Key findings
- Cancer was associated with higher long-term all-cause mortality after LAAO (HR 1.64, 95% CI 1.20 to 2.23, p = 0.002).
- Long-term stroke did not differ significantly by cancer status (HR 0.59, 95% CI 0.30 to 1.15, p = 0.12).
- Long-term bleeding did not differ significantly by cancer status (HR 1.02, 95% CI 0.57 to 1.83, p = 0.94).
- Outcomes did not differ significantly between active and history-of-cancer subgroups (p = 0.146).
Why it matters
These pooled findings help characterize outcomes in a population for whom LAAO evidence has been limited. The higher mortality associated with cancer, alongside no significant differences in stroke or bleeding, underscores the importance of distinguishing overall prognosis from procedure-related thromboembolic and bleeding outcomes when interpreting LAAO data in patients with cancer.
What to keep in mind
The meta-analysis pooled 9 studies; the abstract does not specify their designs or report further limitations.