Do Men and Women Present the Same Evolution after Left Atrial Appendage Closure?

Atrial fibrillation is a very frequent type of arrythmia that affects both men and women alike. This entity is associated to higher mortality seeing as it favors stroke and hospitalization for cardiac failure. 

El cierre de orejuela es seguro con los nuevos dispositivos

At present, one of its valid treatment strategies is left atrial appendage closure, to reduce or prevent stroke and anticoagulation driven bleeding. 

Sex differences in its outcomes and evolution have not yet been looked at. 

This was a meta-analysis of 6 studies including 64,035 patients. 26,120 were women (40.8%) and  37,915 were men.

Compared against men, women had more paroxysmal atrial fibrillation (57.7% vs. 48.2%, p < 0.001) and less diabetes (33.5% vs. 38.7%, p < 0.001), coronary artery disease (35.0% vs. 55.6%, p < 0.001), cardiac failure (33.1% vs. 37.8%, p < 0.001) and kidney failure (13.3% vs. 16.9%, p < 0.001).

The Watchman was used in 4 of the 6 studies, the Amplatzer in one another, and the remaining study used Watchman, Amplatzer, Lariat, Lambre, and Occlutech.

Read also: Drug Coated Balloons in Femoropopliteal Territory: Predictors of Failed Patency.

There were no differences in procedural success (odds ratio [OR]: 0.98, 95% confidence interval [CI]: 0.89–1.09, p = 0.77), but women presented 78% more pericardial complications (OR: 1.78, 95% CI: 1.58–2.01, p < 0.00001), twice as high bleeding rate (OR: 2.04, 95% CI:1.75–2.39, p < 0.00001) and 1.7 times more vascular complications OR: 1.75, 95% CI: 1.41–2.17,p < 0.00001).  

At 2-year followup, there were no differences in mortality or stroke. 

Conclusion

Despite having the same procedural success, women have significantly higher incidence of pericardial complications, major bleeding and vascular complications with left atrial appendage closure. Long term followup showed no difference in mortality or stroke between men and women. 

Dr. Carlos Fava - Consejo Editorial SOLACI

Dr. Carlos Fava.
Member of the Editorial Board of SOLACI.org.

Original Title: Sex differences on outcomes following left atrial appendage occlusion in atrial fibrillation: A systematic review and meta‐analysis

Reference: Yuansong Zhu, et al.  Catheter Cardiovasc Interv. 2022;100:612–619.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...

TAVR in Young Low-Risk Patients

Transcatheter aortic valve replacement (TAVR) has established itself as an effective strategy for the treatment of severe aortic stenosis across different risk groups. While previous...

TAVR and Atrial Fibrillation: What Anticoagulants Should We Use?

The prevalence of atrial fibrillation (AF) in TAVR patients ranges from 15 to 30%, depending on series. This arrhythmia has been associated to higher...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...