Favorable neurological outcome after ischemic cerebrovascular events in patients treated with percutaneous left atrial appendage occlusion compared with warfarin

Oh Hyun Lee, Young Dae Kim, Jung Sun Kim, Hui Nam Pak, Geu Ru Hong, Chi Young Shim, Jae Sun Uhm, In Jeong Cho, Boyoung Joung, Sung Jin Hong, Chul Min Ahn, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Cheol Woong Yu, Hyun Jong Lee, Woong Chol Kang, Eun Seok Shin, Rak kyeong Choi & 6 others Do-Sun Lim, Xavier Freixa, Apostolos Tzikas, Ji Hoe Heo, Yangsoo Jang, Jai Wun Park

Research output: Contribution to journalArticle

Abstract

Objectives: This study sought to investigate neurological disability after ischemic cerebrovascular events in patients treated with left atrial appendage (LAA) occlusion compared with those on warfarin. Background: Prior studies demonstrated that cerebrovascular events after LAA occlusion in patients with nonvalvular atrial fibrillation (NVAF) is largely nondisabling. Methods: From the 1,189 patients in the Korean LAA Occlusion and European Amplatzer Cardiac Plug Multi-Center Registry, 24 patients who experienced ischemic cerebrovascular events after LAA occlusion were enrolled. The neurological outcomes were compared with those in 68 patients who experienced an ischemic cerebrovascular event while on warfarin (Yonsei Stroke Registry). A modified Rankin scale (mRS) score of 3–6 categorized the cerebrovascular event as disabling. The mRS at discharge and at 3 and 12 months postcerebrovascular event in the two groups was compared. Results: The percentages of disabling cerebrovascular events were 37.5% and 58.8% at discharge (P = 0.07), 20.8% and 42.6% at 3 months (P = 0.08), and 12.5% and 39.7% at 12 months (P = 0.02) in the LAA occlusion and warfarin groups, respectively. The mRS was significantly lower in the LAA occlusion group at discharge and at 3 months (P < 0.01) and 12 months (P < 0.01) postcerebrovascular event despite no significant difference in mRS before cerebrovascular events (P = 0.98). Patients in the LAA occlusion group demonstrated a significant reduction in mRS between discharge and 12 months (P < 0.01), unlike patients in the warfarin group (P = 0.10). Conclusions: Ischemic cerebrovascular events in patients who previously underwent percutaneous LAA occlusion for NVAF were more favorable than in patients on warfarin.

Original languageEnglish
JournalCatheterization and Cardiovascular Interventions
DOIs
Publication statusAccepted/In press - 2018 Jan 1

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Atrial Appendage
Warfarin
Atrial Fibrillation
Registries
Stroke

Keywords

  • anticoagulants
  • atrial fibrillation
  • left atrial appendage occlusion
  • stroke

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Favorable neurological outcome after ischemic cerebrovascular events in patients treated with percutaneous left atrial appendage occlusion compared with warfarin. / Lee, Oh Hyun; Kim, Young Dae; Kim, Jung Sun; Pak, Hui Nam; Hong, Geu Ru; Shim, Chi Young; Uhm, Jae Sun; Cho, In Jeong; Joung, Boyoung; Hong, Sung Jin; Ahn, Chul Min; Kim, Byeong Keuk; Ko, Young Guk; Choi, Donghoon; Hong, Myeong Ki; Yu, Cheol Woong; Lee, Hyun Jong; Kang, Woong Chol; Shin, Eun Seok; Choi, Rak kyeong; Lim, Do-Sun; Freixa, Xavier; Tzikas, Apostolos; Heo, Ji Hoe; Jang, Yangsoo; Park, Jai Wun.

In: Catheterization and Cardiovascular Interventions, 01.01.2018.

Research output: Contribution to journalArticle

Lee, OH, Kim, YD, Kim, JS, Pak, HN, Hong, GR, Shim, CY, Uhm, JS, Cho, IJ, Joung, B, Hong, SJ, Ahn, CM, Kim, BK, Ko, YG, Choi, D, Hong, MK, Yu, CW, Lee, HJ, Kang, WC, Shin, ES, Choi, RK, Lim, D-S, Freixa, X, Tzikas, A, Heo, JH, Jang, Y & Park, JW 2018, 'Favorable neurological outcome after ischemic cerebrovascular events in patients treated with percutaneous left atrial appendage occlusion compared with warfarin', Catheterization and Cardiovascular Interventions. https://doi.org/10.1002/ccd.27913
Lee, Oh Hyun ; Kim, Young Dae ; Kim, Jung Sun ; Pak, Hui Nam ; Hong, Geu Ru ; Shim, Chi Young ; Uhm, Jae Sun ; Cho, In Jeong ; Joung, Boyoung ; Hong, Sung Jin ; Ahn, Chul Min ; Kim, Byeong Keuk ; Ko, Young Guk ; Choi, Donghoon ; Hong, Myeong Ki ; Yu, Cheol Woong ; Lee, Hyun Jong ; Kang, Woong Chol ; Shin, Eun Seok ; Choi, Rak kyeong ; Lim, Do-Sun ; Freixa, Xavier ; Tzikas, Apostolos ; Heo, Ji Hoe ; Jang, Yangsoo ; Park, Jai Wun. / Favorable neurological outcome after ischemic cerebrovascular events in patients treated with percutaneous left atrial appendage occlusion compared with warfarin. In: Catheterization and Cardiovascular Interventions. 2018.
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abstract = "Objectives: This study sought to investigate neurological disability after ischemic cerebrovascular events in patients treated with left atrial appendage (LAA) occlusion compared with those on warfarin. Background: Prior studies demonstrated that cerebrovascular events after LAA occlusion in patients with nonvalvular atrial fibrillation (NVAF) is largely nondisabling. Methods: From the 1,189 patients in the Korean LAA Occlusion and European Amplatzer Cardiac Plug Multi-Center Registry, 24 patients who experienced ischemic cerebrovascular events after LAA occlusion were enrolled. The neurological outcomes were compared with those in 68 patients who experienced an ischemic cerebrovascular event while on warfarin (Yonsei Stroke Registry). A modified Rankin scale (mRS) score of 3–6 categorized the cerebrovascular event as disabling. The mRS at discharge and at 3 and 12 months postcerebrovascular event in the two groups was compared. Results: The percentages of disabling cerebrovascular events were 37.5{\%} and 58.8{\%} at discharge (P = 0.07), 20.8{\%} and 42.6{\%} at 3 months (P = 0.08), and 12.5{\%} and 39.7{\%} at 12 months (P = 0.02) in the LAA occlusion and warfarin groups, respectively. The mRS was significantly lower in the LAA occlusion group at discharge and at 3 months (P < 0.01) and 12 months (P < 0.01) postcerebrovascular event despite no significant difference in mRS before cerebrovascular events (P = 0.98). Patients in the LAA occlusion group demonstrated a significant reduction in mRS between discharge and 12 months (P < 0.01), unlike patients in the warfarin group (P = 0.10). Conclusions: Ischemic cerebrovascular events in patients who previously underwent percutaneous LAA occlusion for NVAF were more favorable than in patients on warfarin.",
keywords = "anticoagulants, atrial fibrillation, left atrial appendage occlusion, stroke",
author = "Lee, {Oh Hyun} and Kim, {Young Dae} and Kim, {Jung Sun} and Pak, {Hui Nam} and Hong, {Geu Ru} and Shim, {Chi Young} and Uhm, {Jae Sun} and Cho, {In Jeong} and Boyoung Joung and Hong, {Sung Jin} and Ahn, {Chul Min} and Kim, {Byeong Keuk} and Ko, {Young Guk} and Donghoon Choi and Hong, {Myeong Ki} and Yu, {Cheol Woong} and Lee, {Hyun Jong} and Kang, {Woong Chol} and Shin, {Eun Seok} and Choi, {Rak kyeong} and Do-Sun Lim and Xavier Freixa and Apostolos Tzikas and Heo, {Ji Hoe} and Yangsoo Jang and Park, {Jai Wun}",
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T1 - Favorable neurological outcome after ischemic cerebrovascular events in patients treated with percutaneous left atrial appendage occlusion compared with warfarin

AU - Lee, Oh Hyun

AU - Kim, Young Dae

AU - Kim, Jung Sun

AU - Pak, Hui Nam

AU - Hong, Geu Ru

AU - Shim, Chi Young

AU - Uhm, Jae Sun

AU - Cho, In Jeong

AU - Joung, Boyoung

AU - Hong, Sung Jin

AU - Ahn, Chul Min

AU - Kim, Byeong Keuk

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Hong, Myeong Ki

AU - Yu, Cheol Woong

AU - Lee, Hyun Jong

AU - Kang, Woong Chol

AU - Shin, Eun Seok

AU - Choi, Rak kyeong

AU - Lim, Do-Sun

AU - Freixa, Xavier

AU - Tzikas, Apostolos

AU - Heo, Ji Hoe

AU - Jang, Yangsoo

AU - Park, Jai Wun

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: This study sought to investigate neurological disability after ischemic cerebrovascular events in patients treated with left atrial appendage (LAA) occlusion compared with those on warfarin. Background: Prior studies demonstrated that cerebrovascular events after LAA occlusion in patients with nonvalvular atrial fibrillation (NVAF) is largely nondisabling. Methods: From the 1,189 patients in the Korean LAA Occlusion and European Amplatzer Cardiac Plug Multi-Center Registry, 24 patients who experienced ischemic cerebrovascular events after LAA occlusion were enrolled. The neurological outcomes were compared with those in 68 patients who experienced an ischemic cerebrovascular event while on warfarin (Yonsei Stroke Registry). A modified Rankin scale (mRS) score of 3–6 categorized the cerebrovascular event as disabling. The mRS at discharge and at 3 and 12 months postcerebrovascular event in the two groups was compared. Results: The percentages of disabling cerebrovascular events were 37.5% and 58.8% at discharge (P = 0.07), 20.8% and 42.6% at 3 months (P = 0.08), and 12.5% and 39.7% at 12 months (P = 0.02) in the LAA occlusion and warfarin groups, respectively. The mRS was significantly lower in the LAA occlusion group at discharge and at 3 months (P < 0.01) and 12 months (P < 0.01) postcerebrovascular event despite no significant difference in mRS before cerebrovascular events (P = 0.98). Patients in the LAA occlusion group demonstrated a significant reduction in mRS between discharge and 12 months (P < 0.01), unlike patients in the warfarin group (P = 0.10). Conclusions: Ischemic cerebrovascular events in patients who previously underwent percutaneous LAA occlusion for NVAF were more favorable than in patients on warfarin.

AB - Objectives: This study sought to investigate neurological disability after ischemic cerebrovascular events in patients treated with left atrial appendage (LAA) occlusion compared with those on warfarin. Background: Prior studies demonstrated that cerebrovascular events after LAA occlusion in patients with nonvalvular atrial fibrillation (NVAF) is largely nondisabling. Methods: From the 1,189 patients in the Korean LAA Occlusion and European Amplatzer Cardiac Plug Multi-Center Registry, 24 patients who experienced ischemic cerebrovascular events after LAA occlusion were enrolled. The neurological outcomes were compared with those in 68 patients who experienced an ischemic cerebrovascular event while on warfarin (Yonsei Stroke Registry). A modified Rankin scale (mRS) score of 3–6 categorized the cerebrovascular event as disabling. The mRS at discharge and at 3 and 12 months postcerebrovascular event in the two groups was compared. Results: The percentages of disabling cerebrovascular events were 37.5% and 58.8% at discharge (P = 0.07), 20.8% and 42.6% at 3 months (P = 0.08), and 12.5% and 39.7% at 12 months (P = 0.02) in the LAA occlusion and warfarin groups, respectively. The mRS was significantly lower in the LAA occlusion group at discharge and at 3 months (P < 0.01) and 12 months (P < 0.01) postcerebrovascular event despite no significant difference in mRS before cerebrovascular events (P = 0.98). Patients in the LAA occlusion group demonstrated a significant reduction in mRS between discharge and 12 months (P < 0.01), unlike patients in the warfarin group (P = 0.10). Conclusions: Ischemic cerebrovascular events in patients who previously underwent percutaneous LAA occlusion for NVAF were more favorable than in patients on warfarin.

KW - anticoagulants

KW - atrial fibrillation

KW - left atrial appendage occlusion

KW - stroke

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