Left Atrial Appendage Occlusion Device and Novel Oral Anticoagulants Versus Warfarin for Stroke Prevention in Nonvalvular Atrial Fibrillation

David F. Briceno, Pedro Villablanca, Nicole Cyrille, Daniele Massera, Eric Bader, Eric Manheimer, Philip Aagaard, Kevin J. Ferrick, Jay N. Gross, Soo G. Kim, Andrew K. Krumerman, Eugen C. Palma, Nils Guttenplan, Jorge E. Romero, John Devens Fisher, Mario J. Garcia, Andrea Natale, Luigi Di Biase

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background - Nonvalvular atrial fibrillation is the most common arrhythmia. Patients with nonvalvular atrial fibrillation are at increased risk of stroke; therefore, we evaluated the efficacy and safety of different approaches to prevent this major complication. Methods and Results - We conducted electronic database searches of phase III randomized controlled trials. The groups were novel oral anticoagulants, Watchman left atrial appendage occlusion device (DEVICE), and warfarin. Efficacy outcomes were stroke or systemic embolism, and all-cause mortality. Safety outcome was major bleeding and procedure-related complications. A subgroup analysis of the elderly population was done. We used random-effects model to compare pooled outcomes and tested for heterogeneity. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed for each outcome. Seven randomized controlled trials (n=73 978) were included. There was a significant difference favoring novel oral anticoagulants for systemic embolism (OR, 0.84; 95% CI, 0.72-0.97; P=0.01), all-cause mortality (OR, 0.89; 95% CI, 0.84-0.94; P

Original languageEnglish (US)
Pages (from-to)1057-1064
Number of pages8
JournalCirculation: Arrhythmia and Electrophysiology
Volume8
Issue number5
DOIs
StatePublished - Oct 1 2015

Fingerprint

Atrial Appendage
Warfarin
Anticoagulants
Atrial Fibrillation
Stroke
Odds Ratio
Confidence Intervals
Embolism
Equipment and Supplies
Randomized Controlled Trials
Safety
Mortality
Cardiac Arrhythmias
Databases
Hemorrhage
Population

Keywords

  • anticoagulants
  • atrial appendage
  • atrial fibrillation
  • stroke
  • warfarin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Left Atrial Appendage Occlusion Device and Novel Oral Anticoagulants Versus Warfarin for Stroke Prevention in Nonvalvular Atrial Fibrillation. / Briceno, David F.; Villablanca, Pedro; Cyrille, Nicole; Massera, Daniele; Bader, Eric; Manheimer, Eric; Aagaard, Philip; Ferrick, Kevin J.; Gross, Jay N.; Kim, Soo G.; Krumerman, Andrew K.; Palma, Eugen C.; Guttenplan, Nils; Romero, Jorge E.; Fisher, John Devens; Garcia, Mario J.; Natale, Andrea; Di Biase, Luigi.

In: Circulation: Arrhythmia and Electrophysiology, Vol. 8, No. 5, 01.10.2015, p. 1057-1064.

Research output: Contribution to journalArticle

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