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Percutaneous Left Atrial Appendage Occlusion Yields Favorable Neurological Outcomes in Patients with Non-Valvular Atrial Fibrillation

Authors
 Oh Hyun Lee  ;  Young Dae Kim  ;  Jung Sun Kim  ;  Nak Hoon Son  ;  Hui Nam Pak  ;  Boyoung Joung  ;  Cheol Woong Yu  ;  Hyun Jong Lee  ;  Woong Chol Kang  ;  Eun Seok Shin  ;  Rak Kyeong Choi  ;  Do Sun Lim  ;  Yo Han Jung  ;  Hye Yeon Choi  ;  Kyung Yul Lee  ;  Bang Hoon Cho  ;  Sang Won Han  ;  Joong Hyun Park  ;  Han Jin Cho  ;  Hyung Jong Park  ;  Hyo Suk Nam  ;  Ji Hoe Heo  ;  Chak Yu So  ;  Gary Shing Him Cheung  ;  Yat Yin Lam  ;  Xavier Freixa  ;  Apostolos Tzikas  ;  Yangsoo Jang  ;  Jai Wun Park 
Citation
 KOREAN CIRCULATION JOURNAL, Vol.51(7) : 626-638, 2021-07 
Journal Title
KOREAN CIRCULATION JOURNAL
ISSN
 1738-5520 
Issue Date
2021-07
Keywords
Atrial appendage ; Atrial fibrillation ; Factor Xa inhibitors ; Stroke
Abstract
Background and objectives: Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. Methods: Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment. Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. Results: mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively. Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). Conclusions: Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.
Files in This Item:
T202102666.pdf Download
DOI
10.4070/kcj.2020.0527
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Park, Hyungjong(박형종)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Son, Nak Hoon(손낙훈) ORCID logo https://orcid.org/0000-0002-6192-8852
Lee, Kyung Yul(이경열) ORCID logo https://orcid.org/0000-0001-5585-7739
Lee, Oh Hyun(이오현) ORCID logo https://orcid.org/0000-0001-7070-7720
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/184236
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