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

Prospective Analysis of the Feasibility of the PASCAL System for Transcatheter Mitral Repair: OneForAll Registry

Courtesy of Dr. Juan Manuel Pérez. Mitral transcatheter edge-to-edge repair (M-TEER) is an effective option for patients with severe mitral regurgitation who are at high...

Left Bundle Branch Block after TAVR: What Is Its Impact?

Courtesy of Dr. Juan Manuel Pérez. Left bundle branch block (LBBB) is a common complication following transcatheter aortic valve replacement (TAVR), which can be either...

Multicenter Experience with 3D Intracardiac Echocardiography for Guiding Interventional Cardiac Procedures

Courtesy of Dr. Juan Manuel Pérez. Imaging techniques play a fundamental role in interventional cardiac procedures. Intracardiac echocardiography (ICE) appears as an alternative to transesophageal...

Pathology of Self-Expanding Transcatheter Aortic Bioprostheses and Hypoattenuated Leaflet Thickening

Courtesy of Dr. Juan Manuel Pérez. Despite the available long term followup data on of transcatheter aortic valve replacement (TAVR), bioprosthesis durability continues under debate....

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

ACC 2025 | FAME 3: FFR Guided PCI vs CABG 5 Year Outcomes.

Earlier studies comparing percutaneous coronary intervention (PCI) vs coronary artery bypass graft (CABG) have shown fewer events at long term for the surgical strategy.  However,...

ACC 2025 | API-CAT: Reduced vs. Full Dose Extended Anticoagulation in Patients with Cancer Related VTE

The risk of cancer related recurrent venous thromboembolism (VTE) will drop over time, while bleeding risk will persist. At present, it is recommended we...

STRIDE: Semaglutide in Patients with Peripheral Arterial Disease and Type II Diabetes

Peripheral arterial disease (PAD) is a severe complication in patients with type II diabetes, primarily affecting peripheral vessels, especially below-the-knee (BTK) arteries. This condition...