Pramana Ketut Angga Aditya Putra, Cahyani Ni Gusti Ayu Made Sintya Dwi, Pintaningrum Yusra, Rahmat Basuki
General Practitioner, Faculty of Medicine Mataram University, Mataram, Indonesia.
Interventional Cardiology Division, Cardiology and Vascular Department, Faculty of Medicine, Mataram University, Mataram, Indonesia.
Egypt Heart J. 2024 Oct 22;76(1):144. doi: 10.1186/s43044-024-00576-1.
The purpose of this study is to compare the clinical results of Left Atrial Appendage Closure (LAAC) and oral anticoagulation (OAC) in individuals with AF.
For randomized controlled trials (RCTs) comparing the clinical results of OAC to LAAC in patients with atrial fibrillation (AF), we searched PubMed, ScienceDirect, and Cochrane. The included publications were subjected to meta-analyses using Review Manager v5.4.
In comparison to OAC, LAAC was linked with a decreased incidence of all stroke (OR 0.68; 95% CI 0.55-0.84; p = 0.0004). LAAC was also linked to a decreased risk of hemorrhagic stroke (OR 0.20, 95% CI 0.07-0.55; p = 0.002). There is no statistically significant difference between the two groups in terms of ischemic stroke (OR 1.05; 95% CI 0.59-1.84; p = 0.88) or systemic embolization (OR 1.02; 95% CI 0.42-2.46; p = 0.97).
According to our meta-analysis, the LAAC was less likely than the OAC to have a complete or hemorrhagic stroke. For the two groups, however, there was no difference in the risk of ischemic stroke or systemic embolization.
本研究旨在比较房颤患者左心耳封堵术（LAAC）与口服抗凝药（OAC）的临床效果。
对于比较房颤患者OAC与LAAC临床效果的随机对照试验（RCT），我们检索了PubMed、ScienceDirect和Cochrane。纳入的出版物使用Review Manager v5.4进行荟萃分析。
与OAC相比，LAAC与所有卒中发生率降低相关（比值比[OR]0.68；95%置信区间[CI]0.55 - 0.84；p = 0.0004）。LAAC还与出血性卒中风险降低相关（OR 0.20，95% CI 0.07 - 0.55；p = 0.002）。两组在缺血性卒中（OR 1.05；95% CI 0.59 - 1.84；p = 0.88）或全身性栓塞（OR 1.02；95% CI 0.42 - 2.46；p = 0.97）方面无统计学显著差异。
根据我们的荟萃分析，LAAC发生完全性或出血性卒中的可能性低于OAC。然而，两组在缺血性卒中和全身性栓塞风险方面无差异。
