Age-specific outcomes after transcatheter left atrial appendage occlusion with the watchman device.

IF 2.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Geriatric Cardiology Pub Date : 2025-07-28 DOI:10.26599/1671-5411.2025.07.007

Ritu Yadav, Sia Savant, Meghana Prakash, H Waraich, Abhishek C Sawant

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引用次数: 0

Abstract

Background: Transcatheter left atrial appendage occlusion (LAAO) has become a suitable alternative to anticoagulation in patients with atrial fibrillation (AF). However, outcomes among patients age > 75 years undergoing LAAO are lacking.

Methods: We included 723 consecutive patients with AF undergoing LAAO from August 2015 to March 2020. Patient data including clinical, laboratory, procedural characteristics, medications and outcomes were collected. The primary composite outcome was major adverse cardiac events (MACE) including mortality, stroke, bleeding and readmissions at 60-days.

Results: Mean age was 75 ± 8 years and 434 (60%) were males. Median CHA₂DS₂-VASc score was 4 (IQR: 4, 5) points and median HASBLED score was 4 (IQR: 3, 4) points. Composite MACE outcome was significantly higher among patients age > 75 years in both unadjusted (17.1% vs. 11.5%, P = 0.03) and adjusted (Odds Ratio = 1.59, 95% CI: 1.02 - 2.46, P = 0.04) analysis. Composite MACE was primarily driven by higher all-cause mortality (1.3% vs. 0, P = 0.04) among patients age > 75 years. The secondary outcome of procedural success was also lower among patients age > 75 years (92.2% vs. 96.2%, P = 0.02). The occurrence of stroke (P = 0.38), major bleeding (P = 0.29) and readmissions (P = 0.15) did not differ between patients age > 75 years and less than 75 years.

Conclusion: Patients age >75 years undergoing LAAO have worse outcomes primarily driven by higher all-cause mortality and are less likely to achieve procedural success. Future prospective studies evaluating these findings are warranted.

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经导管左心耳闭塞使用watchman装置后的年龄特异性结果。

背景：经导管左心耳闭塞术（LAAO）已成为心房颤动（AF）患者抗凝治疗的合适选择。然而，年龄在0 ~ 75岁之间的LAAO患者的预后缺乏。方法：从2015年8月至2020年3月，我们纳入了723例连续接受LAAO治疗的房颤患者。收集患者资料，包括临床、实验室、程序特征、药物和结果。主要综合结局为主要心脏不良事件（MACE），包括60天死亡率、卒中、出血和再入院。结果：平均年龄75±8岁，男性434例（60%）。CHA2DS2-VASc评分中位数为4分（IQR: 4,5分），HASBLED评分中位数为4分（IQR: 3,4分）。在未调整的（17.1% vs. 11.5%, P = 0.03）和调整的（优势比= 1.59,95% CI: 1.02 - 2.46, P = 0.04）分析中，bb0 ~ 75岁患者的综合MACE结果均显著较高。复合MACE主要是由bb0 ~ 75岁患者较高的全因死亡率（1.3% vs. 0, P = 0.04）引起的。50 ~ 75岁患者手术成功的次要结局也较低（92.2% vs. 96.2%, P = 0.02）。卒中（P = 0.38）、大出血（P = 0.29）和再入院（P = 0.15）的发生率在75岁和75岁以下患者之间没有差异。结论：年龄在bb0 ~ 75岁的患者接受LAAO的预后较差，主要是由于全因死亡率较高，并且手术成功的可能性较小。未来的前瞻性研究评估这些发现是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Geriatric Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-GERIATRICS & GERONTOLOGY

CiteScore

3.30

自引率

4.00%

发文量

1161

期刊介绍： JGC focuses on both basic research and clinical practice to the diagnosis and treatment of cardiovascular disease in the aged people, especially those with concomitant disease of other major organ-systems, such as the lungs, the kidneys, liver, central nervous system, gastrointestinal tract or endocrinology, etc.