Zweiker David, Bergler-Klein Jutta, Fiedler Lukas, Toth Gabor G, Achleitner Reinhard, Schratter Alexandra, Stix Guenter, Gabriel Harald, Binder Ronald K, Rammer Martin, Pfeffer Michael, Vock Paul, Lileg Brigitte, Steinwender Clemens, Sihorsch Kurt, Hintringer Florian, Adukauskaite Agne, Martinek Martin, Sturmberger Thomas, Ablasser Klemens, Zirlik Andreas, Scherr Daniel
Division of Cardiology, Medical University of Graz, 8036 Graz, Austria.
Third Department for Cardiology and Intensive Care, Clinic Ottakring, 1160 Vienna, Austria.
J Clin Med. 2024 Oct 30;13(21):6514. doi: 10.3390/jcm13216514.
: There are limited data about left atrial appendage closure (LAAC) in patients with cancer. We therefore sought to compare the outcome after LAAC in patients with vs. without cancer in a multicentre registry. : In this sub-analysis of the prospective Austrian LAAC Registry, we analysed consecutive patients undergoing LAAC to assess the relationship between baseline characteristics and outcome in patients with vs. without cancer. Inverse probability weighting was performed to adjust for differences in baseline characteristics. : A total of 486 consecutive patients from 9 centres with a median age of 75 years (IQR 70-79 years; 35.8% female) were included. Fifty-seven patients (11.7%) had a history of cancer. The median CHADS-VASc and HAS-BLED scores were similar in both groups (median [IQR], 4 [4-6] vs. 5 [3-5], = 0.415; 4 [3-4] vs. 3 [3-4], = 0.428 in cancer vs. other patients). Cancer patients were significantly older, and anaemia and gastrointestinal bleeding were significantly more common. Major procedural complications occurred in 5.3% vs. 7.0% ( = 0.276) of patients. The cumulative five-year survival rates were 80.7% and 84.8% in cancer vs. other patients (adjusted hazard ratio for death 1.29 [95% CI 0.67-2.48], = 0.443). There were also no differences in one-year survival (96.1% vs. 94.0%, = 0.582) and five-year event-free survival (64.9% vs. 74.4%, = 0.124). : In daily clinical practice, LAAC has already been accepted as a treatment option in patients with cancer. This retrospective analysis shows that short-term and adjusted long-term complications are similar in patients with vs. without cancer undergoing LAAC.
关于癌症患者左心耳封堵术(LAAC)的数据有限。因此,我们试图在一个多中心登记处比较有癌症和无癌症患者LAAC后的结局。
在这项对前瞻性奥地利LAAC登记处的亚分析中,我们分析了连续接受LAAC的患者,以评估有癌症和无癌症患者的基线特征与结局之间的关系。采用逆概率加权法来调整基线特征的差异。
共纳入来自9个中心的486例连续患者,中位年龄75岁(四分位间距70 - 79岁;女性占35.8%)。57例患者(11.7%)有癌症病史。两组的CHADS - VASc和HAS - BLED评分中位数相似(中位数[四分位间距],癌症患者与其他患者分别为4[4 - 6] vs. 5[3 - 5],P = 0.415;4[3 - 4] vs. 3[3 - 4],P = 0.428)。癌症患者年龄显著更大,贫血和胃肠道出血显著更常见。主要手术并发症发生率在患者中分别为5.3%和7.0%(P = 0.276)。癌症患者与其他患者的累积五年生存率分别为80.7%和84.8%(调整后死亡风险比1.29[95%置信区间0.67 - 2.48],P = 0.443)。一年生存率(96.1% vs. 94.0%,P = 0.582)和五年无事件生存率(64.9% vs. 74.4%,P = 0.124)也无差异。
在日常临床实践中,LAAC已被接受为癌症患者的一种治疗选择。这项回顾性分析表明,接受LAAC的有癌症和无癌症患者的短期和调整后的长期并发症相似。