13. Percutaneous intervention for structural heart disease

Left atrial appendage closure vs oral anticoagulation for atrial fibrillation

PRAGUE 17: 4 years
Objective
to report the 4-year follow-up clinical outcomes comparing left atrial appendage closure (LAAC) with non-warfarin oral anticoagulation for (DOAC) atrial fibrillation (WATCHMAN or AMULET)
Study
prospective multicentre randomised non-inferiority trial (margin 5%)
Population
patients with nonvalvular AF at moderate or high risk for stroke or bleeding (CHA2DS2-VASc ≥3 plus HAS-BLED ≥2)
Endpoints
composite of stroke or TIA, systemic embolism, clinically significant bleeding, death or periprocedural complication
Conclusion
LAAC remains non-inferior to DOAC during median follow-up of 3.5 years for prevention of major cardiovascular, neurological and bleeding events
Osmancik et al. J Am Coll Cardiol. 2022;79:1-14
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The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

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2023 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2024)
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